First time poster - possible FIP?

[madisaid]

Just want to say sorry in advance for the long post – there’s a lot to cover. I adopted Millie from the humane society October of 2018, she was 2 months old. They told me she’d had diarrhea but put her on Purina EN Gastrointestinal food and had seen improvement. I adopted her, kept giving the food and took her to her first appointment. They vet gave her Albon (sulfadimethoxine) for her diarrhea and I put her on Nature’s Instinct Kitten food because I felt better about the ingredients. She responded well and did great until about June of 2019. She started having diarrhea again, every single day but had no other symptoms and her appetite was huge. They ordered a fecal test and she tested positive for Coccidia and we treated her with more Albon again for 14 days – no improvement. Took her back and they gave her 11 days worth of Metronidazole and was put on Hills i/d gastrointestinal food and Proviable probiotics– no improvement. I decided to try a holistic vet to get a second option and maybe a different approach. She did a more intense fecal test and gave her some supplements. Saw little to no improvement but this time she tested positive for Clostridium and Coronavirus (which they told me was super common) She was given Metronidazole for 21 days since this had now been going on for 2 months at this point. After all of this, I was told she was going to need a blood test, x-ray and ultrasound to rule out a multitude of things. I decided to take her back to her original vet and after feeling around her intestines and feeling 3 lumps, we went with an ultrasound. They saw an intussusception and told me surgery was the best course of action so she had a piece of her bowel removed on September 25th. First week after surgery was amazing, her stools were the best I’d seen in months and I was so happy but after a week, we are now back at square one. During her surgery, they sent off a piece of her colon for biopsy and the vet told us on Wednesday that she does not have lymphoma but what they saw from the biopsy results, they suspect dry FIP. I’ve been terrified of this diagnosis and they have sent off her blood for a more intense test that was labeled on the invoice as a “coronavirus” test. Her appetite is huge but she seems like she’s barely digesting anything properly and she seems scared all the time, which is very unusual. She sees the TV on and runs away, she wants nothing to do with anyone and this is not normal. They vet said that if the test comes back and they believe she truly does have FIP, they’d recommend polyprenyl immunostimulant. I’ve seen conflicting arguments about this online and don’t know if this is the best course of action. What other tests or treatments would you guys recommend to determine if she does in fact have FIP? Has anyone had a similar situation to Millie's? I'm attaching the biospy report if anyone is good at reading these because I'm not.

 

[kittenmittens84]

Do you know if they did a full blood chemistry panel and CBC? Those will be useful for diagnosis. Here’s a link to an outline of different signs of FIP and how to go about determining it- Dr. Addie - What is FIP ?

Unfortunately the link to her diagnosis flowchart is broken, but the text covers it.

If it is dry FIP and you want to treat it, don’t waste your money on PI. You’ll want GS-441524, which unlike PI can actually eliminate the virus.

 

[MissClouseau]

Do you have the blood test results? Very hard to make any comment without it. But generally I always recommend getting a second, maybe third opinion for a dry FIP diagnosis. Preferably from a vet/an internist who is known to treat "another vet diagnosed with FIP but turned out it was something else and they treated her for that." Specifically look for reviews like that in your area.

As you know there is no test to diagnose FIP - vets reach to the conclusion based on several different findings from different tests AND clinical symptoms put together and other possibilities ruled out. Obviously my experience is limited to what I read on the internet and conversations with the vet which is a relatively small data but I must say the symptoms here don't sound typical for the dry FIP cases I have heard about. Lack of appetite, fever, lethargy seem to exist if dry FIP affects digestive system and there are issues with liver and/or kidneys.

Did they rule out IBD? Did they check her B12 level?

 

[FeebysOwner]

Hi. I read the biopsy report and wasn't actually sure what was being said one way or the other about the prospects of FIP. I also saw no indication of the biopsied tissue being tested for FIP via a test I thought was the most current and accurate testing available (see link below that explains the test and also diagrams out how they look at symptoms and results to help draw a conclusion about FIP), but again I am not trained to interpret biopsy reports. You might ask the vet about this aspect of testing and see what they say.

https://www.idexx.com/files/feline-infectious-peritonitis-virus.pdf

Although, this following link may be entirely unnecessary (and, I hope it is), here is more about the FIP treatment that K kittenmittens84 mentioned above. This would be something to ask your vet to discuss with you in comparison to the polyprenyl immunostimulant treatment.

General FAQs About Treating FIP Using GS-441524

www.zenbycat.org

 

[Leomc123]

i read the report and it seems they are looking at more of a bacterial or fungal gut (stomach) infections. Toxoplasmosis is a disease caused by the parasite . Its like a food chain reaction, the parasite causes a cyst in a warm blooded animal, when another animal eats this infected food with the parasite they then become infected also as the parasite breeds and causes cysts.

• Eating undercooked meat of animals harboring tissue cysts
  
  .
• Consuming food or water contaminated with cat feces or by contaminated environmental samples (such as fecal-contaminated soil or changing the litter box of a pet cat)
  
  .
• Blood transfusion or organ transplantation
  
  .
• Transplacentally from mother to fetus
  
  .

In the human host, the parasites form tissue cysts, most commonly in skeletal muscle, myocardium, brain, and eyes; these cysts may remain throughout the life of the host.

Toxoplasmosis is not identified in your cat.

Chronic Granulomatous Disease (CGD) is an inherited primary immunodeficiency disease (PIDD) which increases the body's susceptibility to infections caused by certain bacteria and fungi. This was present in the lymp cyst .


Your vet is searching for or suspecting bacateria or fungal infection in the stomach gut He doesnt see toxomaplosis identified in your cat, but he sees that there is evidence of Granulmatous inflamation which is caused by bacteria or fungi

campylobacter infection is present in your cat which is a stomach infection. and the medication Metronizadol isnt working to kill the infection.
He is thinking its more of a bacterial or fungal infection which may be caused by something else other than FIP at this point
I am not a vet but that is what i am understanding from the report.

 

[madisaid]

Thank you so much for all your responses. I do have a blood test and others have indicated this likely does point to FIP but I’m still just not sure.

 

[FeebysOwner]

Maybe it is in another part of the blood test results, but when you earlier said they were sending her blood off for a more intense test that was labeled on the invoice as a “coronavirus” test - that would probably be a titer count. I don't see that in what you posted. The higher the titer count however doesn't mean much because the anti-virulent strain (FECV) of corona virus also elevates the titer count. That is why I asked about the FIP Virus RealPCR test - as that can denote between FECV and the virulent strain (FIPV).

When they biopsied her colon and didn't see lymphoma but suspected FIP - that is the tissue that could have also been used to ID either FECV or FIPV. Do you know if they did that, and that is why they were suspecting FIP? If they didn't, ask if they retained/froze/stored any of the biopsied tissue - and if so, could they still possibly run the FIP Virus RealPCR test on it? With dry FIP, testing the suspected tissue carrying FIP is what is needed, and given she has had GI issues, one could have come to the conclusion that might be where FIP is affecting her, if it is in fact it is affecting her at all. Not a guarantee, but sure would have been helpful to rule out FIP in that tissue at least.

Also, if she has had previous blood tests done, those should be compared to the most current one to see if there have been changes in the areas like Protein and Globulin. Both are just out of range, but if they have always been just out of range, it might not mean anything for her. Likewise with the A/G ratio - and, it is still within range, actually.

The FIP document I shared with you does state that with dry FIP, a suspect of it is Pyogranulomatous inflammation. But, the biopsy report indicates a few other possibilities as noted above by Leomc123 . Also in that report, titer testing is mentioned along with a gms test and a gram test, looking for other microorganisms. The results of these were due in a secondary report. Have you gotten that report yet?

 

[madisaid]

Yeah the "coronavirus" test was just a titer count which I wouldn't have paid for had they explained it differently. I'm going to a new vet tomorrow to get a second opinion so I can ask for a FIP Virus RealPCR test.

As far as I know, they didn't actually test any tissue, they just think that's what it is. I'll ask if they saved it so that it could potentially run it but I may just request it at the new vet either way.

She hasn't had any previous blood tests prior to the one posted which was only completed because she was having surgery. I would like to get another one to compare although, they'd only be about a month apart at this point. I also noticed that it's barely out of range, nothing is significant so I'm really hoping it could possibly be something else.

The secondary report stated that everything else they tested for was negative.

 

[kittenmittens84]

An A/G of <.4 with high globulin is generally considered indicative of FIP.

What do her eyes look like? Any cloudiness or lesions or uneven pupils?

 

[Neko-chan's mama]

I don't know if it will help, but I'll share the symptoms that Figaro had before FIP took him
Anorexia
Weakness
Unusual, wobbly walk
His eyes were kind of jumping around
Failure to grow/gain weight
In his final week, he was unable to walk and had a seizure

 

[gordonsmom]

Has your vet looked into the possibility of IBD? I have a 16 year old cat that has had this for years. While it never goes away, he is on a small dose of prednisone every other day, and when his diarrhea is very bad, centrine helps. Over the years, we tried everything, diet (including raw), other meds, etc. So far this has been working for about 5 years and other than the problems with his bowels, he is a healthy, happy boy.

I did lose one cat to FIP, but it was the wet version so cannot tell you what to expect from the dry version. I don't know if there is a test specifically for that now - there was not 6 years ago when we lost Gordon. Figaro (above post) sounds like the symptoms Gordon had when we lost him.

 

[madisaid]

An A/G of <.4 with high globulin is generally considered indicative of FIP.

What do her eyes look like? Any cloudiness or lesions or uneven pupils?

To me, her eyes look totally normal. Both vets that she's seen have also said her eyes look good. They tested just her protein yesterday and it was on the high end of normal but it's decreased since her last blood test. They also gave her a B-12 injection.

 

[madisaid]

Has your vet looked into the possibility of IBD? I have a 16 year old cat that has had this for years. While it never goes away, he is on a small dose of prednisone every other day, and when his diarrhea is very bad, centrine helps. Over the years, we tried everything, diet (including raw), other meds, etc. So far this has been working for about 5 years and other than the problems with his bowels, he is a healthy, happy boy.

I did lose one cat to FIP, but it was the wet version so cannot tell you what to expect from the dry version. I don't know if there is a test specifically for that now - there was not 6 years ago when we lost Gordon. Figaro (above post) sounds like the symptoms Gordon had when we lost him.

For some reason, they don't think it's IBD even though she has a lot of the symptoms. I guess they ruled it out because of her biopsy. She's getting B-12 injections right now and we're having an internal specialist review her medical history because nothing seems black and white with her, we're in this unfortunate grey area.

 

[madisaid]

I don't know if it will help, but I'll share the symptoms that Figaro had before FIP took him
Anorexia
Weakness
Unusual, wobbly walk
His eyes were kind of jumping around
Failure to grow/gain weight
In his final week, he was unable to walk and had a seizure

Thank you, I'm sorry about Figaro