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Writer's pictureChristopher N. Nguyen

The Basics of FIP: A Quick Run-down

Updated: Feb 12

Feline infectious peritonitis (FIP) presents a formidable challenge for both cats and their caregivers. Let's explore the nature of this virus, its impact, and why diagnosis and treatment have long proven elusive.


The Culprit: Feline Coronavirus (FCoV)

Feline coronavirus is an exceptionally prevalent virus. While many FCoV strains induce minimal (even asymptomatic) effects, specific mutated types trigger the devastating disease we know as FIP.  Interestingly, high-density environments (shelters, catteries), breed predisposition (particularly among purebreds), male sex, and advanced age seem to heighten FIP risk, though the underlying reasons remain an active field of research.


Clinical Forms: 'Wet' & 'Dry'

FIP manifests in two main forms:

  • Effusive ('Wet') FIP: Characterized by fluid accumulation (effusion) within the abdomen or chest, leading to breathing difficulties and visible abdominal distention.

  • Non-effusive ('Dry') FIP: A more insidious presentation, causing inflammation within organs (eye, liver, brain, etc.), yielding diverse symptoms.

Initial FIP signs tend to be frustratingly nonspecific — fatigue, decreased appetite, weight loss, and intermittent fever. This deceptive start mirrors many feline illnesses, hindering a swift diagnosis.


The Diagnostic Dilemma

Unfortunately, no single test yields definitive FIP confirmation. Veterinarians must piece together a diagnosis utilizing:

  • Blood Tests: While suggestive, altered blood values (liver enzymes, protein levels, etc.) can overlap with other diseases.

  • Effusion Analysis: When present, PCR testing of the fluid offers high accuracy but isn't universally applicable.

  • Imaging (X-Ray, Ultrasound): Can reveal abnormalities suggestive of FIP but requires expert interpretation.

  • Tissue Biopsy: This is the most definitive approach for FIP diagnosis. However, the invasive nature and time needed for results create drawbacks in an acutely ill cat.


The Search for Answers

Since its description in the 1950s, intense research into FIP sadly outpaced the development of accurate diagnostics, preventative vaccines, and truly effective treatments. Tragically, for decades, FIP remained an almost certain death sentence.


Managing the Disease and Immune Response

FIP arises from a dysregulated immune response to the mutated FCoV virus.  Conventional treatment strategies focused on immunosuppressants to reduce damaging inflammation but, historically, provided only temporary improvement.


Prevention: a Complex Issue

FCoV's wide distribution among cats presents preventative challenges. The only guaranteed prevention would be the total elimination of FCoV exposure – an impractical prospect. Strategies emphasizing overall feline health, hygiene (litter box cleanliness), and minimizing overcrowding may aid in minimizing risk but shouldn't be viewed as fail-safe.


A Glimmer of Hope

Thankfully, modern breakthroughs offer true hope where none existed before. Antiviral medications, specifically GS-441524 and EIDD-2801 (molnupiravir), now show dramatic remission rates and are fundamentally changing the fight against FIP. If you suspect FIP, immediately consulting your veterinarian is critical – they can discuss testing options and explore newer treatment protocols with compounds such as EIDD-2801 which significantly increase survival for most cats.

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