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and neutrophilic chemotaxis.4


Infected macrophages also recruit and activate additional tissue macrophages.4


Eventually, the proinflammatory cytokines released by recruited macrophages are thought to disrupt the tight junction of endothelial cells resulting in fibrin and plasma leakage into body cavities. Tese cytokines also re- cruit additional neutrophils and macrophages, further damaging the vascular endothelium.4


While the wet form is a relatively easy clinical diagnosis, diagnosis of the dry form remains challenging.5 Non-specific clinical signs associated with the dry form include pyrexia and lethargy. Systemic signs of the dry form include dyspnea, icterus, retinitis, uveitis, ataxia, seizures, nystagmus and palpable abdominal abnormali- ties.1,2


Te gold standard of diagnosis for FIP is histology; however, blood work, fluid analysis, signalment and


clinical signs are tools readily available to the general practitioner. Based on the sample (blood or effusion), using serology to assist in the diagnosis of FIP is of little utility. Te antibody titers measured via serology does not differentiate between the antibodies formed against the enteric FCoV and the non-enteric form responsible for FIP. In other words, only antibodies against FCoV are measured. As healthy cats could shed the virus inter- mittently or lifelong, high serum antibody titers in the absence of clinical signs are likely due to viral replication and shedding.10


FIP; however, this method is of little use since the presence antibodies in an effusion are reflective of antibodies in the blood.1,10


Performing serology on effusions has been shown to carry a high positive predictive value for Tus, obtaining antibody titers is best indicated for screening cats moving between catteries


or assisting an establishment with achieving a FCoV free environment.10 Various diagnostic laboratories offer a Polymerase Chain Reaction test for FIP, which is a reasonable and sensitive alternative to serology.


It is important to note that the following laboratory findings are not uniform in all cats with FIP. Lymphope- nia, neutrophilia, and non-regenerative anemia are possible hematologic indicators of infection.1,2


of the albumin: globulin ratio is the most valuable and predictive diagnostic parameter.1,2 below have documented sensitivities for the increased probability of FIP infection.1,2


Elevation


in liver enzymes, creatinine, total protein, globulins, and bilirubin are useful indicators obtained from an in house chemistry panel.1,2


Although hyperproteinemia is present in both wet and dry forms of FIP, calculation Ratios of 0.8 and


If an effusion is present,


an exudate with low cellularity (protein >3.5g/dL and < 5000 cells per microliter), and an albumin: globulin ratio of <0.5, are reliable predictive parameters for diagnosis of FIP.1,2 Rivalta’s test, using a mixture of distilled water, vinegar and the effusion, is a simple confirmatory test to perform on suspected FIP effusions; however, is not specific for FIP, but rather a high protein effusion.1 Finally, cytological examination of effusion fluid is variable, but macrophages outnumbering normal neutrophils is suggestive of FIP. 1


Cats with feline infectious peritonitis carry a grave prognosis and are either euthanized or succumb to the in- flammatory cascade.


Nearly 60 years after first being described, there are many aspects of FIP that are not well understood. While under the shadow of the current human coronavirus pandemic, it is important to remind clients, staff, and vol- unteers that feline coronavirus is not the same coronavirus responsible for the current pandemic (SARS-CoV-2). Additionally, if owners insist on obtaining coronavirus titers, it is important to reiterate that testing is not dis- criminatory for FIP titers.2,7 FCoV.2,10


Results will only indicate if the cat has been exposed to FCoV or currently shedding Determining the risk of a cat developing FIP or diagnosing FIP only via titers is discouraged.2 


References 1. Levy, JK; Hutsel, S (2014), Overview of Feline Infectious Peritonitis. Retrieved 9/1/2020, from https://www.merckvetmanual.


com/generalized-conditions/feline-infectious-peritonitis/overview-of-feline-infectious-peritonitis


2. UCDavis Koret Shelter Medicine Program (2020). Feline Infectious Peritonitis/Feline Coronavirus (FIP/FCov). Retrieved 9/1/2020, from https://www.sheltermedicine.com/library/resources/?r=feline-infectious-peritonitis-feline-coronavirus-fip-fcov


3. Oguma, K et al. Mutation of the S and 3c genes in genomes of feline coronaviruses. J. Vet Med Sci. 2018. July; 80: 1094-1100 4. Zachary, JF. (2017). Mechanisms of Microbial Infections. In: Pathologic Basis of Veterinary Disease. St. Louis, MO. Elsevier, 2017: 217-218


5. Kipar, A, Meli, ML. Feline infectious peritonitis: still an enigma?. Vet Pathol. 2014. March; 51(2): 505-26 6. Pedersen. A review of feline infectious peritonitis virus infection: 1963-2008. J Feline Med Surg. 2009 April; 11(4): 225-58 7. Cornell Feline Health Center (2020). Feline Infectious Peritonitis. Retrieved 9/1/2020, from https://www.vet.cornell.edu/ departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/feline-infec- tious-peritonitis


8. Pesteanu-Somogyi LD, Radzai C, and Pressler BM. Prevalence of feline infectious peritonitis in specific cat breeds. J. Feline Med Surg. 2006 February; 8(1): 1-5


9. Evermann, JF et al. Biological and pathological consequences of feline infectious peritonitis virus infection in the cheetah. Arch Virol. 1988; 102(3-4): 155-71.


10. Hartmann, K. Feline infectious peritonitis. Vet Clin North Am Small Anim Pract. 2005 January; 35 (1): 39-79 16 KVMA News - Diagnostic Rounds


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