Sarman the cat, FIP, September 13, 2017

FIP (Feline Infectious Peritonitis)

If you started searching for FIP (Feline Infectious Peritonitis) on the Internet, I am really sorry for you. Perhaps your or your family’s cat (or a friend’s, or a relative’s cat) is diagnosed with the disease. I know how do you feel, now you are really sorry, your heart is broken, you feel empty and helpless, and you are searching for a possible cure for this horrible disease. I can understand your feelings because I recently lost my beloved “Sarman” to FIP. And now I am devastated.

What is FIP

FIP is a fatal disease that affects cats. It is caused by a mutation of feline enteric coronavirus (FECV) or simply Feline coronavirus (FCoV). Coronavirus is highly contagious and common but in fact not harmful itself. Most infected cats do not develop FIP. But, in some rare cases, it mutates into feline infectious peritonitis virus (FIPV) – and… it is hard to tell because I know how it hurts, but, there is no known cure for FIP, and very, very few survivors of the disease.

Sarman the cat, FIP, September 13, 2017
I recently lost my beloved “Sarman” to FIP. This photo was taken on September 13, 2017, nine days before his death.

When the Feline coronavirus mutate into FIPV, the cat’s immune system produces antibodies that are supposed to protect the cat. With the “assistance” of these antibodies, white blood cells gets infected with the virus, and these cells then transport the virus throughout the cat’s body – then an intense inflammatory reaction occurs around vessels in the tissues where these infected cells locate, often in the abdomen, kidney, or brain.

Despite the name of the disease contains “Infectious”, actually it is not highly contagious at all. Coronavirus, is highly infectious.

Signs and Symptoms

The earliest signs are the lack of appetite, fewer, weakness, weight loss, jaundice, and diarrhea. Another early sign that I noticed: my lovely boy, Sarman, started lying down on warm places like working PC cases or laptops on his belly. Before he got ill, he usually slept in funny and very cute positions – but suddenly he started looking for these warm places to rest, and lying down on them on his belly. A very, very bad symptom which is an indicator that something was really wrong. He also started eating less and less every day. He stopped playing, even started not paying attention whatever goes around him at all. A few days later, he stopped cleaning (licking) himself.

It’s like a switch – something in my lovely boy just switched off.

There are two types of FIP: Effusive (wet) and non-effusive (dry). In fact both types are fatal, but the effusive form is more common (60-70% of all cases are wet) and progresses more rapidly than the non-effusive form. It is also far more deadly. Almost all of the survivors (which there are very few) developed the dry form. Unfortunately, again, Sarman has developed the wet form.

The hallmark clinical sign of effusive FIP is the accumulation of fluid within the abdomen or chest. I first noticed his lack of appetite and weakness on August 21. In the early September, liquid started accumulating in his belly. This accumulated liquid squeeze the lungs, cause breathing difficulties, and make the cat’s life even worse.

Dry FIP will also present the same signs (i.e. lack of appetite, fewer, weakness, weight loss) but there will not be an accumulation of fluid. Typically a cat with dry FIP will show ocular or neurological signs. For example, the cat may develop difficulty in standing up or walking, becoming functionally paralyzed over time. Loss of vision is another possible outcome of the disease.

In overall, FIP signs and symptoms are:

  • Pain or swelling of the abdomen (wet form)
  • Weight loss (both forms)
  • Lethargy, tiredness and weakness (both forms)
  • Appetite loss (both forms)
  • Seizures and paralysis (dry form)
  • Inflammation of the eyes (dry form)
  • Vomiting, diarrhea, constipation (dry form)

Treatment

Unfortunately, there’s no cure for FIP. Treatment is symptomatic and palliative only. What only you can do is making the cat as comfortable as possible. Effusive FIP (wet form) usually progresses too rapidly, as in my Sarman’s case, for any meaningful therapy to be attempted.

Life Expectancy

In the effusive or wet form, not very much. Perhaps days, or a few weeks. My lovely boy was gone one month after I noticed the first signs of this horrible disease. In the dry form, the life expectancy is higher. I know a cat who diagnosed with dry FIP in January 2016 and as of September 2017, she was still alive.

What can you do

To avoid FIP

First of all, there is no single laboratory test available that can point decisively to FIP. But there are tests like ELISA or IFA to detect if your cat has been in contact with the virus and has developed antibodies to it. If the result of the test is negative, then you are lucky – your cat(s) never contacted with the virus. But, in the future, if you decide to take a new cat, before introducing it to your house cats, take it to your veterinarian and make sure that s/he is also corona negative. If it is corona positive, I would not recommend to take her/him. Because, in any cat infected with FECV (feline coronavirus), there is a chance that the virus may mutate into the FIP-causing form FIPV.

In short, protecting your cat(s) from coronavirus infection dramatically decreases the likelihood of cats developing FIP. You should keep litter box(es) clean and locate them away from food and water. Clean feces from the litter daily and disinfect the box(es) regularly – maybe once a week. Preventing overcrowding, keeping cats current on vaccinations, and providing proper nutrition can also help decrease the occurrence of FIP in groups of cats.

If your cat is diagnosed with FIP

The hard truth again: FIP is incurable. All you can do is making the cat as comfortable as possible, as explained above. And please try to be with her/him as much as possible. You’ll probably be regretful, if you don’t do so.

Is quarantine necessary?

It depends on the situation. If other cat(s) around are Corona positive, no quarantine needed. As explained above, coronavirus is infectious, not FIP. The coronavirus must undergo a mutation in order to lead to FIP. But if other cat(s) are corona negative, yes, you should quarantine the sick cat. You don’t want to make your other cat(s) corona positive. Once a cat is infected with the coronavirus, there will always be a chance (5 to 10 percent, most sources say) that the virus to mutate and the infected cat to develop FIP.

FIP and Polyprenyl immunostimulant (PI)

An experimental polyprenyl immunostimulant is being manufactured by Sass and Sass in Tennessee, United States. It is is classed as a biologic by the USDA. According to the Sass and Sass website they are conducting research on its use for FIP and other diseases of companion animals. Although not currently approved for the treatment of FIP by the USDA, it is being widely used off label for prolonging the life of cats with milder forms of FIP.

According to the UC Davis Veterinary Medicine, “it has not shown any benefit for treating or prolonging life of cats with wet FIP or cats with severe disease signs at the onset of therapy. Although touted on the web and by certain individuals as a way to prolong the life of cats with FIP, in particular the milder dry forms, it is important to review what is known about the efficacy of PI when used for this purpose. PI may cost over $400 a month if used on an average size cat and dosed accordingly and this expense can be magnified by associated veterinary expenses.”

I would recommend you to read the whole article, and make your own decision to use it or not. I do not live in United States, and there were no chance to find the stimulant here where I live in (Istanbul). In fact, Sarman’s health condition deteriorated very rapidly. There was just not enough time… Even there was enough time, after reading the article on Davis’ website, I am really sceptic about that stimulant.

FIP Vaccine

There is only one licensed FIP vaccine available; however, this vaccine has minimal if any effectiveness in preventing FIP, and it is not generally recommended by the American Association of Feline Practitioners Feline Vaccine Advisory Panel. Primucell FIP, produced by Pfizer Animal Health, is a temperature-sensitive, modified-live virus vaccine that is given as an intranasal vaccine, and is licensed for use in cats at least 16 weeks of age.

Not generally recommended – the American Association of Feline Practitioners has grouped vaccines for cats into three general categories:

  1. Core, means all cats should receive the vaccine.
  2. Non-core, means recommendation is based on risk for exposure to the disease
  3. Not generally recommended, means have little or no indication.

The FIP vaccine has been included in this third category. Being in the “not generally recommended” category does not mean the vaccine is bad or dangerous, it simply means that widespread use is not generally recommended among pet cats. If the FIP vaccine is used, antibody testing before vaccination is advised, since cats that have already been exposed and have antibodies don’t benefit from vaccination.

So, the vaccine appears to be safe, but the risks and benefits of vaccination should be weighed carefully. You should consult your veterinarian to help you decide if your cat(s) should be vaccinated.

Story of Sarman

In August 2016, in the North campus of the Bosphorus University, Istanbul (where I work in), I saw a cute, little orange kitten. He was so tiny, so vulnerable. But he was also very timid, scared of everything and everybody – dogs, other cats, people, even me. When I try to give some food to him, he was running away. He was only eating the food after I walked away a bit. Sometimes I was waiting for a certain distance to enable him to eat his food. Because dogs were around.

One morning, while I was walking fast, I noticed that something, something little, was clinging to my leg. I looked down – it was him! The cute little kitten was so hungry that his hungriness has overcome to his fear. And he recognized me, and decided to beg for some food. It was a very emotional moment for me. I gave him some food, he started scoffing. He was adorable! After he finished eating, I took him to my office.

Sarman the orange cat - first meeting (August 16, 2016)
The first day with Sarman – August 16, 2016. He had problem in his eyes – which I treated in a few days.
Sarman the orange cat - first day at the office (August 16, 2016)
The first day at the office (August 16, 2016). He’d already started sleeping in the cutest positions.

After that day, he never left my side. He went wherever I go in the campus. He was waiting me at our office door every morning, and after eating his food, he was sleeping by my side. Sometimes on my desk, sometimes on my lap.

Sarman the orange cat, August 22, 2016
Sarman the orange cat, August 22, 2016. His eyes were much better after the treatment.

In the video below, I am playing with my lovely boy. It was September 16, 2016. I didn’t know I’d lost him almost a year later.

Sarman the orange cat (October 20, 2016)
October 20, 2016. Playing with my little boy. I really miss his beautiful eyes.
Sarman the orange cat, December 7, 2016
December 7, 2016. My lovely Sarman is sleeping on my desk. He was already looking like a grown-up cat.

Winter came. Snow fell (yes, it snows in Istanbul, heavily). I spent many nights at the office with him (ans sometimes with some other cats), to keep him/them warm.

Sarman the orange cat, December 16, 2016
December 16, 2016. Sarman is watching the first snow of the year at my office.

He also had friends. The video below was shot in last winter. The calico cat, who is licking Sarman is Korsan (meaning “pirate”, because she is missing one of her eyes). Sarman was the gentlest cat I ever saw. He was always kind to humans and to another cats.

Sarman the orange cat, June 15, 2017
June 15, 2017. Summer is about to begin. Sarman is enjoying the warm weather.

In the summer of 2017, the FIP has shown its ugly head in our campus (North campus of the Bosphorus University). We lost many cats (mostly kittens, but also a mother cat, her babies were already dead). I feared that my lovely boy would get sick, so I decided to take him home. It was a hard decision because I already have 4 cats at home, and they don’t like the newcomers. Anyway, I took Sarman to the vet for tests. Unfortunately, he was corona positive. My fur babies at home were negative. So I didn’t take the risk.

Unfortunately, on August 21, 2017, I realized something wrong with him. He was less active, eating less. First I thought it was temporary. But, on August 26, I decided to take him to vet. They first said that it was bacterial. I was hopeful. But, his condition was getting worse and worse. On September 5, the veterinary said that he was FIP. Wet form. Terminal. Nothing could be done any more.

I took him back to the university in the same day. Because there was nothing the vet can do any more. I wanted him by my side, in his last days. I wanted him to see the sky, the sun, the trees for a few days more.

Sarman the orange cat, August 11, 2017
The last healthy photo of Sarman. Taken on August 11, 2017. Just in ten days, he’d get terminally ill.

He spent his last days in the neighborhood that he love. Unfortunately, his condition got worse and worse. His belly started getting bigger and bigger. He stopped eating completely. I was feeding him with a syringe. But he was getting skinnier and skinnier. It was really hurting to see him like that.

Sarman the orange cat, September 21, 2017
This photo was taken on September 21 at around 20:00. It was his last photo. In a few hours, he would be dead.

On September 1, he was so sick that I knew he was going to dye. He was hardly breathing, so me and friends took him to the vet. They gave him oxygen. But…

We left him at the vet and I returned home at 1:00 am. At 1:30, the vet called me. My baby was gone. Forever. I started crying.

We buried him the next day. We were in tears…

Thank you for reading this. As I said before, I am also really, really sorry for you and your cat. For me, it was really hard to write this article. Every word broke something inside me. I still love him and miss him. Still, after a few weeks he has gone, I still sometimes crying. Knowing that I lost him, forever… it really, really hurts…

Sources

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