Treatment of FIP
There is no known treatment that can cure FIP once clinical signs arise. Although spontaneous remission in treated cats has been reported, it is uncommon. The mortality rate of clinical FIP is 95%. Cats with the effusive form progress rapidly, usually within 2 mo. The noneffusive form usually is associated with a more prolonged clinical course, with many cats living several months to a year. Treatment with anti-inflammatory and immunosuppressive drugs, along with supportive care, can make the cat more comfortable; in some cats (probably ≤10%), therapy may extend survival time by several months. Treatment is best advised in cats that are in good physical condition, are still eating, have no neurologic signs, and that do not have concurrent FeLV-induced malignancy or bone marrow suppression.
Treatment is directed toward controlling the immune-mediated vasculitis and reducing viral load. The most effective treatments are combinations of prednisolone (4 mg/kg or 50-100 mg/m2 , PO, sid) and cyclophosphamide (2-4 mg/kg, PO, sid for 4 consecutive days of each week). Alternatively, the cyclophosphamide can be given at 50 mg/m2, PO, every 48 hr or 200-300 mg/m2, every 2-3 wk. Other cytotoxic agents may be substituted for the cyclophosphamide, such as chlorambucil at 10 mg/m2, PO, every 2-3 wk. Because this cytotoxic therapy may suppress bone marrow cells, the hemogram should be monitored weekly and the cat observed carefully for signs of sepsis. Supportive therapy for FIP is important and includes broad-spectrum antibiotics, adequate nutrition and fluid intake, and high doses of ascorbic acid (125-250 mg, bid). The use of low doses of aspirin (10 mg/kg every 48-72 hr) may be useful as an anti-inflammatory and possibly antithrombotic agent when used along with the steroids and cytotoxic agents. Treatment directed toward controlling the virus includes systemic interferon-a (10,000 U/kg, SC, sid or 1.3 million U/m2 , SC, 3 times/wk).
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