Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines

Abstract

Feline coronavirus (FCoV) is a ubiquitous RNA virus of cats, which is transmitted faeco-orally. In these guidelines, the European Advisory Board on Cat Diseases (ABCD) presents a comprehensive review of feline infectious peritonitis (FIP). FCoV is primarily an enteric virus and most infections do not cause clinical signs, or result in only enteritis, but a small proportion of FCoV-infected cats develop FIP. The pathology in FIP comprises a perivascular phlebitis that can affect any organ. Cats under two years old are most frequently affected by FIP. Most cats present with fever, anorexia, and weight loss; many have effusions, and some have ocular and/or neurological signs. Making a diagnosis is complex and ABCD FIP Diagnostic Approach Tools are available to aid veterinarians. Sampling an effusion, when present, for cytology, biochemistry, and FCoV RNA or FCoV antigen detection is very useful diagnostically. In the absence of an effusion, fine-needle aspirates from affected organs for cytology and FCoV RNA or FCoV antigen detection are helpful. Definitive diagnosis usually requires histopathology with FCoV antigen detection. Antiviral treatments now enable recovery in many cases from this previously fatal disease; nucleoside analogues (e.g., oral GS-441524) are very effective, although they are not available in all countries.

Measurement of Feline Alpha-1 Acid Glycoprotein in Serum and Effusion Using an ELISA Method: Analytical Validation and Diagnostic Role for Feline Infectious Peritonitis

“…According to the Bayesian approach [ 49 ], if the pre-test the probability of FIP is low, as in the example of septic effusions described above, the diagnosis of FIP remains unlikely, even in the presence of high AGP values. Conversely, AGP may be used as a confirmatory test when other findings consistent with FIP are present (e.g., yellowish and sticky, gross appearance of the fluid; high protein content; high LDH:TNCC ratio; and non-specific inflammatory cytology) [ 3 , 12 , 13 ] or may act as a discriminating marker for FIP when some but not all of the findings listed above are present and, therefore, the pre-test probability is intermediate. Conversely, independent of the clinical scenario, low AGP values in sera or effusions may allow FIP to be ruled out.…”

“…Recently, antiviral treatments have been established and demonstrated to be effective [ 1 , 2 , 3 ], although a few side effects have been reported [ 4 , 5 , 6 , 7 ] and very little information is available about possible long-term effects [ 7 , 8 ]. Treatment is recommended where the drugs is legally available [ 3 ], but unfortunately, in the large majority of countries, the drug is not licensed; therefore, treatments are not allowed. Therefore, an accurate diagnosis is mandatory either to treat the cats or to decide on euthanasia.…”

Emergence and spread of feline infectious peritonitis due to a highly pathogenic canine/feline recombinant coronavirus

“…The electronic records of Vet Dia Gnosis in Limassol, Cyprus were searched for any positive FCoV RT-PCR cases from September 2021 up to August 2023. The cases to be enrolled needed to have compatible clinicopathological findings for FIP as recently outlined by the European Advisory Board on Cat Diseases Guidelines 25 as well having a positive RT-PCR for FCoV in one of the following samples: peritoneal fluid, pleural fluid, cerebrospinal fluid and granuloma fine needle aspiration biopsies or tissue biopsies. The original samples were submitted to the Vet Dia Gnosis commercial laboratory (Limassol, Cyprus) by local veterinarians and then submitted to LABOKLIN commercial laboratory (Bad Kissingen, Germany).…”

“…FIPV causes feline infectious peritonitis (FIP), which is a fatal disease if left untreated. Clinical signs include an abdomen swollen due to peritoneal fluid, fever, weight loss lethargy, anorexia, dyspnoea, ocular abnormalities and neurological signs 8,16,24,25 . Mutations in the spike gene or the accessory genes 3abc and of 7ab of FCoV 8,16,23,26 are thought to result in changes to the virus’s tropism from cells in the enteric tract to macrophages, resulting in the different disease presentation seen with the two biotypes.…”

Assessing the feasibility of applying machine learning to diagnosing non-effusive feline infectious peritonitis

“…For the majority of cases, the de facto methodology for diagnosing FIP relies on the use of a complex decision-making system requiring a panoply of laboratory test results together with expert clinical interpretation. The Advisory Board for Cat Diseases (ABCD) has published a series of recommended diagnostic approaches for FIP, which illustrates the complexities surrounding the interpretation of clinical signs and the diagnostic tests utilised 15 . On the basis of history, signalment, clinical signs and laboratory tests, a high level of suspicion of FIP can be determined.…”