Fip Misdiagnosis?

boges55

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I adopted sweet Freya from a local shelter. She was born on 5/8/2018 making her almost 7 months old now. On 9/18, when she was 4 1/2 months old, she went in for her spay. The vet noticed fluid in the stomach and drained it. However, the fluid was not the sticky straw yellow associated with FIP at the time. About three weeks later, in early/mid October they took more fluid and observed that the consistency and color had changed and they detected higher levels of protein. They suspected FIP and that the stress of the spay may have caused the onset.

Blood work and cytology were done on 10/19 (results attached). The cytology recommended a PCR test. On 11/2, we received the PCR results (attached) which showed positive in the stomach (peritoneal) fluid sample and negative in the feces sample.

She has been on daily Prednisolone and herbal Rutin since mid October. She is on a raw meat diet from frozen (e.g. Primal, Small Batch). She just lays most of the time and her stool is soft, but not runny. She still eats normally (maybe even more than normal due to the Prednisolone), grooms herself and purrs. Everything I read says that when a cat gets wet FIP, they deteriorate quickly and they seldom live more than a few weeks, maybe a couple months, and some die in just days. I suspect much of this correlates as to the timing of the diagnosis which in Freya's case appears to be early.

Regardless, since it's been 9/18 since her distended stomach was first observed and she does not appear to have changed much - (no worse, no better), I am starting to wonder if it could be something else. Any ideas would be appreciated? Thank you!
Freya belly.jpg
 

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FeebysOwner

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Hi. I would press to see if there are any other testing that the vet could do. As you said, usually diagnosis of FIP is followed relatively quickly by rapid decline and - ultimately death. That is what happened with my Tawny, although he was 15 yo at the time. There is no definitive test to absolutely confirm FIP. The only test that could definitively rule it out would be a test for the corona virus, which is what can - but not necessarily - mutate into FIP. I really wasn't able to understand the PCR test enough - are they telling you it is positive for corona? Sorry, I was confused. But, I will tell you, more cats than not test positive for corona. And, many, many of them never have it mutate to FIP.

The thing is, if is FIP, the belly swelling would continue because the fluid isn't just going to stop accumulating. And, from my experience with Tawny his eating and activity dropped drastically in a very short period of time. I wish I could remember the exact time line, but he passed away in 1991, so my memory is pretty foggy. We did have his belly drained at least 3 times, because it kept growing in size. But that changed nothing for him in terms of eating, just comfort.

The one thing that the vet can do is drain the fluid from the belly - again, and then you can start observing how long it take again to accumulate. The vet will likely fight you against additional testing, but IMO, it couldn't hurt - other than putting her through it.
 

Mamanyt1953

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I wish I could add more, but I'm a bit stymied. This may well be FIP, but it is not typical FIP. If it is at all possible for you, you might try taking her to a University with a Veterinary Medical School. This will almost certainly NOT be less expensive than a regular vet, but they are teaching cutting-edge medicine, with the most up-to-date diagnostic tools and treatments available.

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boges55

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Thanks for the reply. With respect to the corona virus (FCoV), the PCR tested positive for it in the stomach fluid, but negative in the feces. They said to ignore the feces testing because it just means she was not shedding the virus in that particular stool.

I am considering getting another blood work done on her to see if the A/G ratio has changed. My understanding is that if it is less than .5, then there is a strong correlation to FIP. It was .4 at the last test.

It's just puzzling to me why, albeit thankfully, she is still doing reasonably well considering the wet FIP diagnosis approximately 3 months ago.
 

FeebysOwner

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Hi. Are you sure the A/G ratio is a clear indicator of FIP? The only reason I ask is because isn't the A/G ratio also indicative of just the corona virus alone? Sorry, no such testing went on back when Tawny became ill (or, not that I was aware of anyway).

You sound pretty knowledgeable on this matter, but just in case this article can give you any additional insight...

FIP - still a diagnostic challenge;Feline infectious peritonitis;corona virus (FCoV)
 
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boges55

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I don't know if there is anything that is a clear indicator of FIP which is the problem in diagnosing FIP. I think everything is just correlations. The article you linked to states, "A value of 0.8 (or lower) for the serum albumin to globulin ratio strongly supports a diagnosis of FIP." A couple of the other sites I read used a value of .5 or lower. So Freya's last test with an A/G ratio of .4 would apparently support a diagnosis of FIP, but it still does not make it certain. I don't know what other diseases have low A/G ratios. If there are other possible diseases, then I could look into what tests may be available to start a process of elimination.
 

FeebysOwner

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I also found this, if it is any more helpful. But, the statement below indicates there are other diseases/causes for a low A/G ratio.

Albumin to Globulin Ratio(ALB/GLOB): Both of these are serum proteins. A high ratio can indicate nephrosis and liver dysfunction where a low ratio can indicate chronic infection, liver and kidney disease, and autoimmune disorders.

I will keep looking...
 

brendalee007

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Your Freya looks like my cat. Can you share what happened with her? I am wondering what the final diagnosis was, and how long she was with you. Perhaps each FIP case can also vary depending on owner treatment/environment, and it sounds like you were doing a lot of the right things to help prolong quality of life and slow progress of this terrible affliction.
 

FeebysOwner

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B brendalee007 - boges55 boges55 hasn't been on this site since last December, so I don't know whether they will respond to your inquiry.

Sad to say, there are many threads about FIP on this site, and I have included a link below to a lot of them in case you would like to look through them for some insight/information. You can also start your own thread with your questions and concerns too.

Search Results for Query: FIP
 
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