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Symptoms of FIP

Initial exposure to the FIP virus usually results in no obvious clinical disease, although some cats may experience a mild upper respiratory disease that is characterized by sneezing, watery eyes, and watery nasal discharge. Some cats may experience a mild intestinal disease. Most cats that undergo the primary infection completely recover, although some of them may become virus carriers. Only a small percentage of exposed cats develop the lethal disease: weeks, months, or perhaps years after primary infection.

The onset of clinical signs of lethal FIP may be sudden (especially in kittens), or the signs may gradually increase in severity over a period of weeks. Many cats have nonspecific signs such as intermittent inappetence, depression, rough hair coat, weight loss, and fever.

The major forms of lethal FIP are effusive (wet) FIP, noneffusive (dry) FIP, and combinations of both. The most characteristic sign of effusive FIP is the accumulation of fluid within the abdomen and/or chest. When fluid accumulation becomes excessive, it may become difficult for the cat to breathe normally.

The onset of noneffusive FIP is usually slower. Fluid accumulation is minimal, although weight loss, depression, anemia, and fever are almost always present. Signs of kidney failure (increased water consumption and urination), liver failure (jaundice), pancreatic disease (vomiting, diarrhea, diabetes), neurologic disease (loss of balance, behavioral changes, paralysis, seizures), enteritis (vomiting, diarrhea), or eye disease (inflammation, blindness) may be seen in various combinations. FIP is often a difficult disease to diagnose because each cat can display different signs that are similar to those of many other diseases.

The acute or primary infection often is asymptomatic, but in some cases, fever of unknown origin, conjunctivitis, and other upper respiratory signs and diarrhea may occur. This stage may last several days or weeks or longer before signs of effusive or noneffusive FIP develop. Cats with effusive FIP are often presented after the owner notices progressive distention of the abdomen due to ascites. About one-third of cats with effusive FIP have pleural involvement and dyspnea, often accompanied by chronic fluctuating fever (102-106°F [39-41°C]) lasting 2-5 wk, anorexia, weight loss, and depression.

Cats with noneffusive FIP may have a history of vague illness, including chronic fever, malaise, weight loss, and occasionally major organ system failure (renal, hepatic). Overt ocular and CNS signs may occur simultaneously or independently. About 50% of all cats with noneffusive FIP have signs related to intra-abdominal involvement (kidney, liver, spleen, pancreas, lymph nodes); ~60% of cases exhibit either CNS or ocular signs, or both; and ~15% present with ocular signs only. Only 10-15% of noneffusive cases have lesions of the pleural cavity. Many cats have elements of both the effusive and noneffusive forms of FIP.

Ocular disease may manifest as a bilateral anterior uveitis with iritis or iridocyclitis, hyphema, aqueous flare, hypopyon, or keratic precipitates in the anterior chamber. Posterior chamber involvement may include chorioretinitis with subretinal fluid exudation or hemorrhage and secondary bullous or linear retinal detachment. Fundic lesions may include perivascular cuffing, engorgement of retinal veins, and retinal hemorrhage.

Involvement of the CNS in the noneffusive form may cause focal or diffuse lesions in the brain or spinal cord; ~40% of these cases have CNS signs occurring either alone (25%) or in combination with other organ involvement. Clinical signs are variable and may reflect primary spinal cord, cranial, or cerebellar disease. The most common neurologic signs, in order of decreasing frequency, are posterior incoordination and paresis progressing to generalized ataxia, dorsal hyperesthesia, convulsions, personality changes, and hyperesthesia.

Lesions: In classic effusive FIP, there is diffuse peritonitis or pleuritis (or both) characterized grossly by variable amounts of viscous abdominal or thoracic fluid, deposition of gray-white exudate, and disseminated necrotic plaques (0.5-3.0 mm) on the visceral and parietal peritoneum or pleura. Fibrinous adhesions, particularly between the liver and diaphragm and between loops of bowel, can develop in protracted cases; occasionally, the omentum may be contracted into the anterior abdomen as a thickened mass of fibrinous adhesions. Histologically, lesions are characterized by perivascular necrosis and fibrinonecrotizing or pyogranulomatous inflammation; FIPV particles are seen within macrophages at the periphery of lesions.

Gross lesions in noneffusive FIP consist of multiple, gray-white, raised nodules (0.5-2 cm or larger) in kidneys, visceral lymph nodes, liver, intestines, lungs, eyes, and brain. A single, obstructive, granulomatous intestinal mass is seen in some cases. Histologically, the lesions are perivascular granulomas or pyogranulomas with systemic vasculitis or thrombovasculitis. Ocular lesions may affect either anterior or posterior chambers causing anterior uveitis and iridocyclitis or chorioretinitis, retinitis, retinal hemorrhage and detachment, and optic neuritis. Lesions in the CNS affect the brain and spinal cord and can cause either focal granulomatous masses or more diffuse fibrinonecrotizing or pyogranulomatous meningitis and ependymitis. Occasionally, CSF flow is obstructed by inflammatory exudate, and obstructive hydrocephalus develops.




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