VERY UPSET, Possible FIP

I took my little girl to the vet yesterday because she had a prolonged flareup of what I'd been told all along, was FHV or FCV. I had a full blood analysis run and her protein levels are high. She has to be re-tested in 3 weeks. If they are still elevated, or, if they come back higher, it is likely FIP, which, until today, I had never heard of, and wish I never had. 

I would be absolutely devastated. She has become such a loving and well behaved cat. I am beside myself. I realize there is no definitive diagnosis yet but I'm thinking about looking into holistic/homeopathic treatments. Everything I've read has been horrific and heartbreaking. I feel so bad for this cat. 

I have three other cats in the house and I'm very worried about them too. 

I posted yesterday that my cat's protein levels were high and she has cold symptoms. She did not have
a fever at that time. The vet wants to wait 3 weeks before re testing and checking for corona and FIP. I wasn't familiar with FIP before this but now that I am, 3 weeks sounds like a long time to wait. Should Ibring her back sooner?
Part of the problem is that she talked me into Convenia, which lasts 2 weeks, and I never would have given, had she been honest with me when I asked about the side effects. But would antibiotics alter the test results?

Total protein can be elevated due solely to dehydration, especially if her blood chemistry and blood cell counts are normal.

A chronic URI usually involves diagnostics for bacteria or fungi specific to the respiratory tract, rather than jumping to FIP, which is fairly uncommon. I consistently see it in crowded cattery cats, or hoarding situations with many many unhealthy cats all living together. Not that there aren't outliers, they're just rare, as in I see 2 or 3 a year amongst 2000+ feline patients.

For a stubborn URI, beyond home nebulization and antibioitics for 4 weeks minimum, I'll perform a nasal flush under sedation, saving some discharge from the trachea to send off for histopath, as well as eradicating all the purulent debris currently in the upper airway. This can limit bacterial replication, removing the medium the bacteria lives in, giving the antibiotics a better opportunity to be effective.

If pneumonia is discerned when listening to his chest, and/or on thoracic radiographs, then a trans-tracheal wash is a good "next diagnostic" to send a pathology sample from deeper in the respiratory tract than the nasal passages.

Convenia is better for superficial bacterial infections, such as a wound or skin infection, ie miliary dermatitis, FAD, pyoderma, rather than a respiratory infection. But, when there is the possibility a cat won't ingest and absorb their oral antibiotics, it's one of few other options. I've used it since 2007 and only seen a single local reaction, less than reactions I've seen to longer-used injectable analgesia and short-term antibioitics, low incidences of risk with all these treatments that have helped treat painful and sick patients. The immeasurable benefit from injectable meds for veterinary use keeps it in our arsenal for pets and their people.

My really fractious URI patients have to be hospitalized on IV anxiolytics and antibiotics just to be successfully treated, as they won't let their people even apply transdermal meds, of limited efficacy, let alone take oral meds. Convenia is definitely something we try before we hospitalize them, unless we know their infection is too severe for it to be at all efficacious.

For non-emergencies, it's important you find a vet you can feel comfortable communicating with, trust, and know he/she stays on top of their continuing ed, aware that there are minimal risks with every treatment, and they network, using their resources to consult other vets, not too proud or ignorant to ask others for help and opinions. Keeping this vet for reasons of proximity as an emergency resource is good. But, increasing your search radius, casting a wider net, to find a better diagnostician would behoove you and your girl.

Good Luck!

I don't know about the tests for FIP but I know it's very difficult to get a 100% diagnose while the cat is still alive. It's usually diagnosed in an autopsy.

The Convenia shot shouldn't interfere with any FIP testing as FIP is a virus, not a bacteria. 

If your little girl is diagnosed with FIP sadly it is 100% fatal. All you can do is help with end of life care. 

I hope it's not FIP for your little ones sake (and yours).

In regards to your other kitties, they should be fine. In most cases FIP doesn't usually spread through healthy communities. Most kitties at some point in their life are exposed to the virus and it's just a small percentage go on to develop FIP. If it is FIP there isn't much you can do to protect your other guys. Keep you other kitties healthy and stress free; the kitties prone to get it are seniors, kittens, and immune-comprised kitties. (If your guys are due for vaccines I'd talk to vet about delaying their vaccines too) Also don't bring any new kitties to your home until at least 6 months after the last cat with FIP passes away. 

Oh and you may want to look into lysine treatment for you little one if she does have herpes. It's what helped my guy finally but his herpes into remission.

wannahelp said:

 
I took my little girl to the vet yesterday because she had a prolonged flareup of what I'd been told all along, was FHV or FCV. I had a full blood analysis run and her protein levels are high. She has to be re-tested in 3 weeks. If they are still elevated, or, if they come back higher, it is likely FIP, which, until today, I had never heard of, and wish I never had. 

I would be absolutely devastated. She has become such a loving and well behaved cat. I am beside myself. I realize there is no definitive diagnosis yet but I'm thinking about looking into holistic/homeopathic treatments. Everything I've read has been horrific and heartbreaking. I feel so bad for this cat. 

I have three other cats in the house and I'm very worried about them too. 

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Nothing in what you describe sounds like FIP and a positive corona test is by itself essentially meaningless for diagnosis since it is not a test for FIP but is a test for exposure to a common cold.In very rare instances the corona virus can mutate into FIP, but a corona test by itself proves nothing expect that your cat, like many, have been exposed to a cold.

Most cats with FIP get profoundly sick quickly, so sick that the owner may seek emergency treatment.  The more common wet version of FIP causes fluid in the abdomen, and the cat can appear near death very quickly.  Unless your cat's place of origin (shelter etc) had a history of FIP cats, or unless your cat was profoundly ill (beyond a bad cold flare up) I wouldn't worry, ubless there is something else going on that you haven't related to us. I would seek a second opinion.

Is anyone familiar with the LTCI treatment for FIP? Is it effective?

1.) How is your cat's appetite? Any weigh loss? What is her activity level like?

2.) At this point, I have to agree with StephenQ that, based on the info provided, it doesn't sound like FIP is the likely issue.

3.) Any treatment available for FIP is simply trying to improve the quality of life, not the quantity. And, as of now, there is no cure for neither the wet nor dry form of FIP.

For our last FIP case, we used Polyprenyl Immunostimulant (PI). She lived a total of 14 weeks from the initial diagnosis (she had lost weight and was labeled "failure to thrive" despite eating 6-8 oz of wet food daily at onset of diagnosis.)

Aside from having upper respiratory symptoms, does your cat have any other issues??

Right now, her activity level is normal and her appetite is good.

The vat did not weigh her. What kind of weight loss are we talking about and how fast?

wannahelp said:

 
Is anyone familiar with the LTCI treatment for FIP? Is it effective?

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This article makes it clear that LTCI treatment is basically limited to cats with the dry form, and needs early diagnosis.

http://www.examiner.com/article/treating-fip-with-lymphocyte-t-cell-immunomodulator-1

Hmm. Is it typical for your vet to not do a weight check?

I'm talking an obvious weight loss. G appeared malnourished, despite eating. When she should have been about 8 lbs in weight, it was a daily struggle to keep her in the 5-5.5 lb range. On PI, she *slowly* gained weight; but, I'm talking 0.5-1.0 oz every 5-7 days.

In essence, FIP caused an absorption problem that prevented her body from utilizing the food she was eating. This also led to a lack of energy. Her appetite did eventually decrease, especially when she developed the wet form.

I think I would be looking at getting a second opinion from another vet, potentially at a different clinic.

I had to take my dog to see his vet, so I asked him for his opinion.I showed him the blood work results and he said that, since, the individual protein levels were at the high end of normal, they were creating an artificially high total protein level. He said that he would not be concerned about re-testing her. 

I don't know that I feel completely confident with that answer either. Any input on this recent opinion?

If she does have FIP, how long would it take for the levels to rise further?

I agree that at the moment, it may well not be FIP, and I hope it is not because although it is possible to delay the full effects of some cases of FIP (especially of the dry variant), there have so far been no scientifically substantiated cases of recovery. It is a horrible disease. It is also true that some cats are PTS on a diagnosis that is faulty, because FIP symptoms can mimic a number of other conditions, including heart disease. So it is important to do every test possible and retest as necessary, and even then you cannot be 100% sure. Loss of weight, fever that does not respond to antibiotics or anti-inflammatories, vomiting, and above all fluid in the abdomen are all indicators of FIP but nothing more than that. So it becomes a case of treating symptoms and making the cat as comfortable as possible for as long as possible and taking decisions accordingly.

Opinion is also divided on whether FIP is contagious or not. As said above, up to 80% of cats living in multi-cat households will test positive for the Corona virus that mutates sometimes into FIP. Some research indicates that once it mutates in one cat it is contagious until symptoms show, after which it is not transferable. This is not much help for an owner of course. I lost 2 foster cats to FIP some years ago, unrelated cats brought into the household a few weeks apart but who then shared living space away from my own cats. First the kitten and then the adult developed fevers and weight loss and finally both died of FIP. I monitored my own cats very carefully and after discussions with my vet, I also treated them all for 6 months with immune boosters, including Transfer Factor, though again opinion is divided on its efficacy. 4 years later, all are in good health though they are all positive for corona virus.

Good luck, I hope the outcome in your case is good, and that there is another reason for your cat's problems.

As of today, her congestion has not cleared up. Other than that, everything is the same (that I can observe). I'm concerned about the fact that it isn't clearing up. However, if Convenie is not the ideal URI antibiotic, then I guess it's understandable. 

Clavamox and Doxycycline are often the antibiotics we use to treat URIs. However, there is a new antibiotic called Veraflox that is designed specifically to treat herpes related bacterial infections. We used the latter on a kitten with a chronic history that just couldn't catch a break. We used 5 days of Veraflox paired with 10 days of Polyprenyl Immunostimulant. The treatment is costly ($150+); but, she has not had a reoccurrence in 10 weeks. Prior, she was nearly constantly on meds for 6 months.

CatPack said:

Clavamox and Doxycycline are often the antibiotics we use to treat URIs. However, there is a new antibiotic called Veraflox that is designed specifically to treat herpes related bacterial infections. We used the latter on a kitten with a chronic history that just couldn't catch a break. We used 5 days of Veraflox paired with 10 days of Polyprenyl Immunostimulant. The treatment is costly ($150+); but, she has not had a reoccurrence in 10 weeks. Prior, she was nearly constantly on meds for 6 months.

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We also use Clavamox or Doxycycline for URI's.  Is your cat not on either?

@CatPack given the cost of Veraflox, did you do any PCR testing for FHV prior to Tx?

@StephenQ, we did biopsy the ulcer's on her mouth prior to treatment, though I honestly don't remember exactly what the results were.

We were trying to get her well enough to spay and, at 10 months of age, this was kind of our "pull the big guns out" to get her well. We were terrified that the stress of surgery would send her into the worst flare-up to date. Luckily, that wasn't the case and meds worked.

We had practically no doubt in what we were dealing with (FHV and Calicivirus.) We've had her from 6 wks and she and her brother were some of the sickest kittens we have ever had. So bad that the brother passed of cardiomyopathy (not HCM) due to damage to the heart by Calicivirus. (Up to then, I had no idea that Calicivirus could cause organ damage like that.)

All in all, we don't regret for one second doing this med protocol. And, would repeat on another cat in a heartbeat.

**I also want to add, that it is the Polyprenyl that is the bulk of the overall cost I mentioned previously. I think the Veraflox is about $50. But, that is for a whole bottle (though small) and could be used for more than 1 course of treatment.

Originally, I was told, without definitive testing, that my cat probably had FHV or FCV. I was told by another vet in the same practice, that without eye involvement, it likely was not FHV. Now, I'm wondering if it could have been corona all along.

FHV does usually involve eye problems, however it can present differently in different cats. On congestion, my Persil had a chest cough and cold, with inflamed eyes, for four months recently, while we tried to find the right combination of antibiotics to treat her. Eventually we discovered with a biopsy that she had a combination of viruses and a month of doxycycline was necessary, both orally and as eye ointment, to clear it up.