FIP: wrong diagnostic?

Hi!

I posted here a while ago about my cat being diagnosed with dry FIP. My heart broke and I was ready to put her to sleep, 'cause she was beginning to feel pain and was only losing more and more weight.

Now I don't buy the hypothesis of FIP in her case. Her viral score was medium-high (the lab counted as "0 = not FIP, 1-2 = previous exposure, 3-4 = previous or current exposure, >4 = current infection" - she scored 3.), and she had no anemia: only lymphopenia and low platelet count, and liver abnormalities "MAYBE compatible with hepatotoxicity or acute hepatopathy" (but the technician said it could be congenital and was not weird enough to be related with her symptoms). No swollen lymphnodes or any problem with the chemical panel.

The symptoms were just apathy, lethargy, anorexia, non-localized pain and fever.

Aaaaand... she's getting better and better. Three days ago she started to eat on her own again, and is gaining weight fast. She's more active and affectionate, too.

Is it normal for a cat FIP-positive to get better before getting worse?
Or does it only go downhill after the dx?
Are these just "good days" and she will be sick again?
What other problems could cause those symptoms?

I'm optimistic, but worried at the same time. Every day I try harder and harder to prove she's not going to die so soon. One of my hypothesis was feline depression, but the vet said depressed cats don't get feverish...

Except for fever and pain, those symtoms could be related to just about anything. What made you think she was in pain? How high was her fever. Fever in cats can cause severe headache. Come to think of it...also lethargy and anorexia. What were her very first symptoms and how long ago? FIP IS VERY HARD TO DIAGNOSE CONCLUSIVELY, especially dry FIP. The lab values you mentioned do not even suggest FIP much less diagnose it. There is no blood test that is diagnostic for FIP. There are tests that can suggest the presence of a corona virus but there is more than one strain and a lab test cannot distinguish the ones that mutate into FIP from the ones that don't. Low lymphocytes could be related to many things

First, I'm happy to hear about the improvements!

Does she still have fever? You mention her gaining weight. Is the weight evenly dispersed or is it just in her belly?

This is this issue with diagnosing FIP. There is not test that can tell you if it is or is not FIP. Even doing a titer test doesn't tell you...an elevated number does indicate exposure to Coronaviris; but, a negative test does not indicate a lack of exposure.

Cats with FIP do not typically improve significantly. They do have good days and bad; but if she is consistently improving, having a good appetite, playing, has a healthy coat appearance and is gaining weight appropriately (meaning, not just in her belly...an overall weight gain) I think you can breathe a little. But, I wouldn't yet let my guard completely down.

We have a cat in our rescue that got sick with Coronavirus when he was about 8 months old. His titer was through the roof and all were convinced he had FIP. He lost weight and was quite sickly for at least a few months. (I don't remember specifics as I didn't have much interaction with him at the time.)

Well, he slowly began to improve on antibiotics and supportive car. Five years later he is still with us. His growth appears stunted (he's quite smaller than his twin brother) and he has some chronic health issues (Megacolon and Hypertrophic Cardiomyopathy) but, he is active, playful, good appetite and is quite the happy kitty.

On the flipside, we've lost a few to both dry and wet FIP.

I think the longer your kitty can go and continue to show signs of improvement and is thriving, you can begin to take FIP off the table.

caseyv said:

Except for fever and pain, those symtoms could be related to just about anything. What made you think she was in pain? How high was her fever. Fever in cats can cause severe headache. Come to think of it...also lethargy and anorexia. What were her very first symptoms and how long ago?

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The vet said she was in pain 'cause her third eyelid was showing too much. Andraste also assumed a weird hunched position many times while walking or sitting. I said "non-localized" 'cause the vet couldn't find the place that hurt specifically.

The first symptoms appeared almost four weeks ago. She stopped eating, stopped grooming herself, kept herself hidden in a box, had a high fever (the vet didn't tell me the temperature exactly - I need to ask more questions the next time) and was trembling way too much. The few times she got out of the box to go to the litter box she would lay down several times to rest.

The first thing I noticed was the anorexia. The vet said she could be feeling nauseous. Like I said, three days ago she started to eat again without my help, and things just got better.

CatPack said:

Does she still have fever? You mention her gaining weight. Is the weight evenly dispersed or is it just in her belly?
 

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Her body is going back to normal, I guess, and very fast. She's eating like there's no tomorrow. She's still doesn't have her pot belly back, and I don't see swollen parts or anything of sorts. This friday the vet measured her temperature and said she was still a little too warm.

Thank you all again for the replies.

caseyv again...oops fat finger mistake. Lymphocytopenia by itself is hard to interpret. Low platelets are very common on a standard CBC. They form aggregates (clump together) so the count is pretty much meaningless. Did anyone suggest artifact. An accurate count requires a blood sample in a different tube annd preservative. Wet FIP goes downhill quickly usually. Dry FIP can be around a long time before the cat has significant symptons. Neurological problems are common. FIP-POSITIVE cats can have better days and really bad days, but they almost never have a recovery like you describe YOUR FURBABY having. You may never know what actually caused her symptoms. Feline viruses are like that. The research is nowhere near as extensive as with dogs. Research requires money. For that we need to convince the world that cats are every bit as valuable, as loving, as deserving as dogs. After all we(cats, dogs, white people and who knows what else) came to this continent at the same time, in the same boats. LOL I am not a vet. I was a Burn/trauma RN for years and there is some amount of cross over. The information I am giving you comes from recent experience. I have several Felv positive rescue lovies. Some of them were bottle babies. In the last year three of them have died. All three needed 24/7 care. The lovy Jonathan Popper is beside me on this bed right now. He is dying. All four of these four legged children were fine one morning and by supper time were not. They all presented with different symtoms. One lived three months with progressive paralysis and severe weight loss until we had to empty his bladder with a needle. Believe me,we tried every alternative. One lived nearly a year. Her only symptom was continual weight loss. She started ou at 11 lbs and ended at 3 lbs even though she ate like a horse. One lived three days after being diagnosed with pancytopenia because her bone marrow was not functioning at all. We transfused her but red cells only live for 72 hours. I have been through all the lab stuff...xrays,ultrasound, differential diagnosis (ONE OF WHICH WAS FIP), second opinions,third opinions,veterinary accupuncture. They suggested cell cultures, myelograms, exploratory surgery, chemotherapy. Bottom line...each time I asked them, what are the odds that THIS painful test will turn up something that can be fixed. What are the odds that what ever you learn will change treatment. Answer was always,"umm very low odds." The concensus...probably Felv related lymphoma. I know WAY more about it now than I ever wanted to. It comes in many forms. It works in many ways. So my dear...I guess I have used your post to answer, not just your questions, but those of many others dealing with similar pain. I hope you never have to consider "THE GOOD DEATH" ever again.

PPS: OBVIOUSLY I took a long time out...Johnny pop needed me...and then didn't check to see if you had responded. Third eyelid or lids, yeah they come out for all kinds of reasons. I have never heard the pain connection. I will have to check it out. Hunching and hiding, yup. If a cat can,t hide sickness or illness they feel more vulnerable; afraid of becoming prey not predator. It is hard wired and they can't help it. The first thing that clued me my Alice was very sick was hiding. When I could get her out from under my dresser she would tremble and purr...to comfort herself I think. My point is; I cannot for the life of me think why your vet would have guessed FIP. Like any other profession...there are vets and then there are vets...some compassionate and competent and others just plain cruel, lazy, impatient, burned out, bitter, disillusioned with their lives, arrogant, mercinary or prone to
care about one kind of animal and not others. NEVER take ANYONES word for it that your companion is terminal. Research for yourself. Keep on asking questions..."why do you think that, what else could it be, why this drug/treatment/test/procedure, why NOT that drug/treatment...etc. Any info that is available to your vet is available to you if you keep looking. Learning does not happen only in a degree program any more. Be confident and persistent. Do not allow yourself to be pushed toward a decision when your gut is yelling NONONO. If you don't know for sure in your heart that your loves care giver is one of the good ones...get another. Consider euthanasia ONLY when you are sure you have been given all the truth that exists and when your love is telling you what she needs and wants. I was pushed hard by two young male vets to accept that my Rory's quality of life was not good enough and that unless I agreed I was being selfish. They both insisted that since Rory couldn't speak for himself than they had to protect him by speaking for him. They were saying all this out in the waiting room after spending 5 minutes with Rory. I hesitated a moment to consider what my gut, heart, and head were saying. I knew they believed what they were saying but that the way they were going about it SUCKED. I also knew they were wrong. I got mad and LOUD. Just like people, each cat is unique. And like relationships between people, relationships with cats are unique and cover the same huge range of possibilities. HOW DARE THEY PRESUME TO KNOW RORY BETTER THAN I DID. HOW DARE THEY PRESUME THE RIGHT TO BULLY ME INTO MAKING A DECISION THAT WAS NOT THEIRS OR MINE TO MAKE. HOW DARE THEY PRESUME TO SIT IN JUDGEMENT OF WHAT A QUALITY EXPERIENCE WAS FOR RORY. It was not up to them. It was not even up to me. It was up to Rory. If they really believed that animals were incapable of communicating their opinions and desires than they had no business being care givers. Communication between people is about 20% verbal and 80% nonverbal. Some of us are better at it than others. Some us want to and some us don't. It's the same with cats. Rory talks to me all the time. I talk to him just exactly like I am talking to you. Most of the sounds are just noise to him but I assure

(yet another fat finger. I am sorry I am so bad at this. It is the first time I have posted on this site. I keep triggering things I don't want to and I don't know yet how to navigate here. While I am at it...I apologize for indulging myself in such a long rant. I spent most of my adult life in a LIBERAL multicultural college town. Than I married a farmer...OOPS! I new it would be a cultural adjustment but OMG. Rural agricultural Iowa is still living socially in the 1960s. It is probably a good thing I am isolated out here on the farm. If the other folks out here knew what I really think about most things they would probably stone me. I didn't really intend to vent at such great lengths but I am still living this story. Johnny Pop is going down hill. Each day he is more debilitated. I am approaching yet another end of life and I am so raw. There is no one here to talk to. They all think I am pretty weird already. I live on a farm but my cats ARE NOT BARN CATS. I don't know if this rant will benefit anyone else. But it's sure been good for me))) (picking up where I left off before my fat finger fup)...but I assure you... he understands the emotion and intent; not just by tone and volume and pitch and cadence. I am very sure he can read all the body language that goes with the noises I am making. Especially the ones other people aren't aware of. His quality of life is enough for him. It might not be for another cat. But Rory is not ready to throw in the towel. He wants to experience every moment of this life that is left to him. He has more grace than any human I have ever known. He will tell me quite clearly when its time...with his eyes when he blinks for yes and looks away for no...with his voice,
with every position and movement of his body...with the quality of his purr...with the way he touches me. And when he does leave it will probably be as a mercy to me more than to him. Now, bring me Rory, and BUTT OUT!

Thank you, Caseyv, and thanks for sharing your story! You are very helpful, in more than one way... Information + empathy are so important

I live in southern Brazil, veterinarians are hard to come by, and most people treat their pets with home remedies and superstition, true veterinarian science is a luxury. Andraste has a vet, so she's more privileged than most cats or dogs around here (heck, she's more privileged than a lot of people). Andraste is my first cat, so your point of view is much appreciated! I admire so much the fact you are that aware of your cats' feelings, I hope I have that in me too...

Yeah, I guess I need another vet... She allegedly is a feline specialist, but I don't know if she's too experienced. You mentioned "artifact", I had to google that (my english is not too good) - yeah, the vet asked me if she squirmed too much when drawing blood. And, in fact, Andraste fought like a champ against the needle. I don't know if that could alter the results too much. And, about the symptoms... Yeah, the fever could cause all of them, I haven't thought about that. Thanks.