A diagnosis of FIP means that they've diagnosed one of the Corona Viruses
(not FIP), and then made a best-guess of FIP, so I'm not sure I'd trust a
diagnosis of FIP.
Gloria
----- Original Message -----
From: "Jennifer Phaewryn O'Gwynn" <[EMAIL PROTECTED]>
To: <felvtalk@felineleukemia.org>
Sent: Tuesday, December 12, 2006 2:34 PM
Subject: Re: urgent help-fip cat going to be pts tommorow...help!!!
FIP is 100% fatal, usually in a short time period. If she indeed is
showing FIP
symptoms, she wont make it long anyways, euthanasia IS a humane
alternative. HOWEVER,
if she is ONLY corona positive and NOT showing symptoms of FIP, then
that's entirely
different. Many shelters fail to understand WHAT Corona is, and that is
NOT the same
as FIP. Sounds like that may be the case here. I know you are just
desperately trying
to save this one cat, BUT, there is a MUCH BIGGER issue at stake here. I
hope you may
be willing to work on it once you understand (even if the understanding
comes too
late for this one kitten), so, in that hope, here goes:
Education is the key. You need to call a meeting with the shelter's board
of
directors (if they are non-profit, they are required to have a board), and
you need
to come to that meeting fully prepared with facts, statistics, and studies
that show
the facts about Corona virus, and it's relation to FIP. You see, it's
simply not the
same thing. The fact that this kitten's brother succumbed to FIP does NOT
mean that
she will, EVEN if she is corona positive. While it's a sad fact that many
shelters do
euthanise any cats that test positive for Corona (in the mis-informed hope
of
stopping the spread of the virus), it's not a policy based on any good
science.
Infection with Coronavirus (Feline Enteric Corona Virus, or FECV) is
actually very
common in cats but most of the time it does not cause any problems, other
than maybe
mild diarrhea. Occasionally, the virus mutates within an infected cat, and
it is this
mutated form that causes the disease of FIP. 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
rescues!!!
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. While the word is still out as to exactly
what causes
the Corona virus to mutate into FIP in certain cats, studies indicate that
it may be
a genetic predisposition (suspected due to cats of a close relation often
succumbing
together), or a specific strain of Corona (suspected due to FIP cropping
up in
specific closed populations in unique geographic locations), or a
combination of both
of those variables.
In addition, diagnosing FIP is highly tricky, and the fact that you are
sending out a
biopsy and implying that this kitten's fate rests on it's result further
shows the
lack of education on the part of the shelter taking that action. Because
most cats
will test positive for Corona and NEVER get FIP, it makes the diagnosis
very complex,
and that is further complicated by the fact that there are two specific
forms of FIP,
wet FIP and dry FIP. The best way to get a good SUSPICION of FIP diagnosis
is be
running several lab tests, and interpreting the result of them all, and
the relation
of those to each other. if they ALL lean towards a FIP diagnosis, THEN one
can begin
to assume FIP exists in the cat. REMEMBER, THERE IS NO TEST THAT CAN
DIAGNOSE FIP ON
A LIVING CAT, THE CAT MUST BE DEAD AND SUBMITTED FOR NECROPSY TO GET A
TRUE FIP
DIAGNOSIS. Here is the proper diagnostic testing recommendations for a
LIVE cat:
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 FIPA 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, it’s 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 [EMAIL PROTECTED] 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.
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, it’s
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.
Remember: a healthy cat with a FCoV antibody titre is NOT a cat with dry
FIP.
Here are more links to read, and sources to quote in your efforts to
change the
MISINFORMED POLICY of this shelter you are representing:
http://www.dr-addie.com/WhatIsFIP.htm
http://orionfoundation.com/moreinfo.htm
http://www.fabcats.org/fip.html
http://www.vet.cornell.edu/fhc/brochures/fip.html
http://www.newmanveterinary.com/fip.html
http://www.bemikitties.com/felv/fipfacts.html
I do hope that you will pursue this matter to the best of your ability,
much more
than this one kitten's life is at stake, if you are successful in
educating this
shelter, you stand to save HUNDREDS to THOUSANDS of cats in the future.
This could
put into effect a policy change that could still be saving cats long after
you have
passed on from this world (people have had entire shelter wings dedicated
in their
name for less). I strongly encourage you to TRY to make these changes in
that
shelter. No, you might not be successful, but if even a LITTLE of the
education you
offer rubs off on even one board member, that could have trickle down
effects in the
long run. Yes, posting one kitten out to the internet is a valid and noble
cause, but
you could do SO MUCH MORE by just educating youself about Corona and FIP,
and then
passing that knowledge on to others! I wish you all the best in your
efforts!
Phaewryn
Please save Whitey! http://ucat.us/Whitey.html
VT low cost Spay&Neuter, and Emergency Financial Assistance for cat
owners:
http://ucat.us/VermontLowCost.html
Special Needs Cat Resources: http://ucat.us/domesticcatlinks.html
