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Journal of Feline Medicine and Surgery logoLink to Journal of Feline Medicine and Surgery
. 2009 Jul 1;11(7):594–604. doi: 10.1016/j.jfms.2009.05.008

Feline Infectious Peritonitis: ABCD Guidelines on Prevention and Management

Diane Addie 1, Sándor Belák 2, Corine Boucraut-Baralon 3, Herman Egberink 4, Tadeusz Frymus 5, Tim Gruffydd-Jones 6, Katrin Hartmann 7, Margaret J Hosie 8, Albert Lloret 9, Hans Lutz 10, Fulvio Marsilio 11, Maria Grazia Pennisi 12, Alan D Radford 13, Etienne Thiry 14, Uwe Truyen 15, Marian C Horzinek 16
PMCID: PMC7129471  PMID: 19481039

Abstract

Overview Feline Coronavirus infection is ubiquitous in domestic cats, and is particularly common where conditions are crowded. While most FCoV-infected cats are healthy or display only a mild enteritis, some go on to develop feline infectious peritonitis, a disease that is especially common in young cats and multi-cat environments. Up to 12% of FCoV-infected cats may succumb to FIP, with stress predisposing to the development of disease.

Disease signs The ‘wet’ or effusive form, characterised by polyserositis (abdominal and/or thoracic effusion) and vasculitis, and the ‘dry’ or non-effusive form (pyogranulomatous lesions in organs) reflect clinical extremes of a continuum. The clinical picture of FIP is highly variable, depending on the distribution of the vasculitis and pyogranulomatous lesions. Fever refractory to antibiotics, lethargy, anorexia and weight loss are common non-specific signs. Ascites is the most obvious manifestation of the effusive form.

Diagnosis The aetiological diagnosis of FIP ante-mortem may be difficult, if not impossible. The background of the cat, its history, the clinical signs, laboratory changes, antibody titres and effusion analysis should all be used to help in decisionmaking about further diagnostic procedures. At the time of writing, there is no non-invasive confirmatory test available for cats without effusion.

Disease management In most cases FIP is fatal. Supportive treatment is aimed at suppressing the inflammatory and detrimental immune response. However, there are no controlled studies to prove any beneficial effect of corticosteroids.

Contributor Information

Diane Addie,    draddie@btinternet.com.

Sándor Belák,  .

Corine Boucraut-Baralon,  .

Herman Egberink,  .

Tadeusz Frymus,  .

Tim Gruffydd-Jones,  .

Katrin Hartmann,  .

Margaret J Hosie,  .

Albert Lloret,  .

Hans Lutz,  .

Fulvio Marsilio,  .

Maria Grazia Pennisi,  .

Alan D Radford,  .

Etienne Thiry,  .

Uwe Truyen,  .

Marian C Horzinek,  .

References

  1. de Vries AAF,Horzinek MC,Rottier PJM,de Groot RJ.The genome organization of the nidovirales: Similarities and differences between arteri-, toro-, and coronaviruses.Semin Virol. 1997;8:33-47 [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Addie DD,Schaap IA,Nicolson L,Jarrett O..Persistence and transmission of natural type I feline coronavirus infection.J Gen Virol. 2003;84:2735-44 [DOI] [PubMed] [Google Scholar]
  3. Herrewegh AA,Smeenk I,Horzinek MC,Rottier PJ,de Groot RJ.Feline coronavirus type II strains 79–1683 and 79–1146 originate from a double recombination between feline coronavirus type I and canine coronavirus.J Virol. 1998;72:4508-14 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Pedersen NC,Evermann JF,McKeirnan AJ,Ott RL.Pathogenicity studies of feline coronavirus isolates 79–1146 and 79–1683.Am J Vet Res. 1984;45:2580-85 [PubMed] [Google Scholar]
  5. Pedersen NC.Virologic and immunologic aspects of feline infectious peritonitis virus infection.Adv Exp Med Biol. 1987;218:529-50 [DOI] [PubMed] [Google Scholar]
  6. ScottFW Update on FIP. Proceedings of the 12th Kal Kan Symposium, 1988: 43–7. [Google Scholar]
  7. Horzinek MC,Osterhaus AD.Feline infectious peritonitis: A worldwide serosurvey.Am J Vet Res. 1979;40:1487-92 [PubMed] [Google Scholar]
  8. Addie DD,Jarrett O..A study of naturally occurring feline corona-virus infection in kittens.Vet Rec. 1992;130:133-37 [DOI] [PubMed] [Google Scholar]
  9. Addie DD.Clustering of feline coronaviruses in multicat households.Vet J. 2000;159:8-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Herrewegh AA,de Groot RJ,Cepica A,Egberink HF,Horzinek MC,Rottier PJ.Detection of feline coronavirus RNA in feces, tissues, and body fluids of naturally infected cats by reverse transcriptase PCR.J Clin Microbiol. 1995;33:684-89 [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Addie DD,Toth S,Murray GD,Jarrett O..The risk of feline infectious peritonitis in cats naturally infected with feline coronavirus.Am J Vet Res. 1995;56:429-34 [PubMed] [Google Scholar]
  12. Pesteanu-Somogyi LD,Radzai C,Pressler BM.Prevalence of feline infectious peritonitis in specific cat breeds.J Feline Med Surg. 2006;8:1-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rohrer C,Suter PF,Lutz H..The diagnosis of feline infectious peritonitis (FIP): A retrospective and prospective study.Kleintierprax. 1993;38:379 [Google Scholar]
  14. Hartmann K..Feline infectious peritonitis.Vet Clin North Am Small Anim Pract. 2005;35:39-79 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. LutzHGutMLeuteneggerCMKinetics of FCoV infection in kittens born in catteries of high risk for FIP under different rearing conditions. Proceedings of the Second International Feline Coronavirus/Feline Infectious Peritonitis Symposium, Glasgow, Scotland, 2002. [Google Scholar]
  16. Addie DD,Jarrett O..Use of a reverse-transcriptase polymerase chain reaction for monitoring feline coronavirus shedding by healthy cats.Vet Rec. 2001;148:649-53 [DOI] [PubMed] [Google Scholar]
  17. Pastoret PP,Henroteaux M..Epigenetic transmission of feline infectious peritonitis.Comp Immunol Microbiol Infect Dis. 1987;1:67-70 [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Addie DD,Jarrett O..Control of feline coronavirus infection in kittens.Vet Rec. 1990;126:164. [PubMed] [Google Scholar]
  19. Pedersen NC,Allen CE,Lyons LA.Pathogenesis of feline enteric coronavirus infection.J Feline Med Surg. 2008;10:529-41 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Horzinek MC,Lutz H..An update on feline infectious peritonitis.Vet Sci Tomorrow. 2001;1:1-8 [Google Scholar]
  21. Vennema H,Poland A,Foley J,Pedersen NC.Feline infectious peritonitis viruses arise by mutation from endemic feline enteric corona-viruses.Virology. 1998;243:150-57 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Cornelissen E,Dewerchin HL,Van Hamme E,Nauwynck HJ.Absence of surface expression of feline infectious peritonitis virus (FIPV) antigens on infected cells isolated from cats with FIP.Vet Microbiol. 2007;121:131-37 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rottier PJ,Nakamura K,Schellen P,Volders H,Haijema BJ.Acquisition of macrophage tropism during the pathogenesis of feline infectious peritonitis is determined by mutations in the feline corona-virus spike protein.J Virol. 2005;79:14122-30 [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Poland AM,Vennema H,Foley JE,Pedersen NC.Two related strains of feline infectious peritonitis virus isolated from immunocompromised cats infected with a feline enteric coronavirus.J Clin Microbiol. 1996;34:3180-84 [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Dye C,Siddell SG.Genomic RNA sequence of feline coronavirus strain FCoV F1Je.J Feline Med Surg. 2007;9:202-13 [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Addie DD,Jarrett O..Control of feline coronavirus infections in breeding catteries by serotesting, isolation and early weaning.Feline Pract. 1995;23:92-5 [Google Scholar]
  27. Dewerchin HL,Cornelissen E,Nauwynck HJ.Replication of feline coronaviruses in peripheral blood monocytes.Arch Virol. 2005;150:2483-500 [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Kipar A,May H,Menger S,Weber M,Leukert W,Reinacher M..Morphologic features and development of granulomatous vasculitis in feline infectious peritonitis.Vet Pathol. 2005;42:321-30 [DOI] [PubMed] [Google Scholar]
  29. Harvey CJ,Lopez JW,Hendrick MJ.An uncommon intestinal manifestation of feline infectious peritonitis: 26 cases (1986–1993).J Am Vet Med Assoc. 1996;209:1117-20 [PubMed] [Google Scholar]
  30. de Groot-Mijnes JD,van Dun JM,van der Most RG,de Groot RJ.Natural history of a recurrent feline coronavirus infection and the role of cellular immunity in survival and disease.J Virol. 2005;79:1036-44 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Gunn-Moore DA,Gruffydd-Jones TJ,Harbour DA.Detection of feline coronaviruses by culture and reverse transcriptase-polymerase chain reaction of blood samples from healthy cats and cats with clinical feline infectious peritonitis.Vet Microbiol. 1998;62:193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Kipar A,Baptiste K,Barth A,Reinacher M..Natural FCoV infection: Cats with FIP exhibit significantly higher viral loads than healthy infected cats.J Feline Med Surg. 2006;8:69-72 [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Dewerchin HL,Cornelissen E,Nauwynck HJ.Feline infectious peritonitis virus-infected monocytes internalize viral membrane-bound proteins upon antibody addition.J Gen Virol. 2006;87:1685-90 [DOI] [PubMed] [Google Scholar]
  34. Paltrinieri S,Cammarata MP,Cammarata G,Comazzi S..Some aspects of humoral and cellular immunity in naturally occuring feline infectious peritonitis.Vet Immunol Immunopathol. 1998;65:205-20 [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Haagmans BL,Egberink HF,Horzinek MC.Apoptosis and T-cell depletion during feline infectious peritonitis.J Virol. 1996;70:8977-83 [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Gonon V,Duquesne V,Klonjkowski B,Monteil M,Aubert A,Eloit M..Clearance of infection in cats naturally infected with feline coronaviruses is associated with an anti-S glycoprotein antibody response.J Gen Virol. 1999;80:2315-17 [DOI] [PubMed] [Google Scholar]
  37. Weiss RC,Scott FW.Pathogenesis of feline infectious peritonitis: Pathologic changes and immunofluorescence.Am J Vet Res. 1981;42:2036-48 [PubMed] [Google Scholar]
  38. Vennema H,de Groot RJ,Harbour DA, et al.Early death after feline infectious peritonitis virus challenge due to recombinant vaccinia virus immunization.J Virol. 1990;64:1407-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. de Groot RJ,Horzinek MCThe coronaviridae. Siddell SG, ed. New York: Plenum Press; 1995:293-309. [Google Scholar]
  40. Addie DD,Toth S,Murray GD,Jarrett O..The risk of typical and antibody enhanced feline infectious peritonitis among cats from feline coronavirus endemic households.Feline Pract. 1995;23:24-6 [Google Scholar]
  41. Wolfe LG,Griesemer RA.Feline infectious peritonitis.Pathol Vet. 1966;3:255-70 [DOI] [PubMed] [Google Scholar]
  42. Kipar A,Koehler K,Bellmann S,Reinacher M..Feline infectious peritonitis presenting as a tumour in the abdominal cavity.Vet Rec. 1999;144:118-22 [DOI] [PubMed] [Google Scholar]
  43. Trulove SG,McCahon HA,Nichols R,Fooshee SK.Pyogranulomatous pneumonia associated with generalized non-effusive feline infectious peritonitis.Feline Pract. 1992;20:25-9 [Google Scholar]
  44. Norris JM,Bosward KL,White JD,Baral RM,Catt MJ,Malik R..Clinicopathological findings associated with feline infectious peritonitis in Sydney, Australia: 42 cases (1990–2002).Aust Vet J. 2005;83:666-73 [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Kline KL,Joseph RJ,Averill DR.Feline infectious peritonitis with neurologic involvement: Clinical and pathological findings in 24 cats.J Am Anim Hosp Assoc. 1994;30:111-18 [Google Scholar]
  46. Foley JE,Rand C,Leutenegger C..Inflammation and changes in cytokine levels in neurological feline infectious peritonitis.J Feline Med Surg. 2003;5:313-22 [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Timmann D,Cizinauskas S,Tomek A,Doherr M,Vandevelde M,Jaggy A..Retrospective analysis of seizures associated with feline infectious peritonitis in cats.J Feline Med Surg. 2008;10:9-15 [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Cannon MJ,Silkstone MA,Kipar AM.Cutaneous lesions associated with coronavirus-induced vasculitis in a cat with feline infectious peritonitis and concurrent feline immunodeficiency virus infection.J Feline Med Surg. 2005;7:233-36 [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Trotman TK,Mauldin E,Hoffmann V,Del Piero F,Hess RS.Skin fragility syndrome in a cat with feline infectious peritonitis and hepatic lipidosis.Vet Dermatol. 2007;18:365-69 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Paltrinieri S,Comazzi S,Spagnolo V,Giordano A..Laboratory changes consistent with feline infectious peritonitis in cats from multicat environments.J Vet Med A Physiol Pathol Clin Med. 2002;49:503-10 [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Sparkes AH,Gruffydd-Jones TJ,Harbour DA.An appraisal of the value of laboratory tests in the diagnosis of feline infectious peritonitis.J Am Anim Hosp Assoc. 1994;30:345 [Google Scholar]
  52. Pedersen NC.The history and interpretation of feline coronavirus serology.Feline Pract. 1995;23:46 [Google Scholar]
  53. Gunn-Moore DA,Caney SM,Gruffydd-Jones TJ,Helps CR,Harbour DA.Antibody and cytokine responses in kittens during the development of feline infectious peritonitis (FIP).Vet Immunol Immunopathol. 1998;65:221-42 [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Hartmann K,Binder C,Hirschberger J, et al.Comparison of different tests to diagnose feline infectious peritonitis.J Vet Intern Med. 2003;17:781-90 [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Hayashi T,Ishida T,Fujiwara K..Glomerulonephritis associated with feline infectious peritonitis.Nippon Juigaku Zasshi. 1982;44:909-16 [DOI] [PubMed] [Google Scholar]
  56. Shelly SM,Scarlett-Kranz J,Blue JT.Protein electrophoresis on effusions from cats as a diagnostic test for feline infectious peritonitis.J Am Anim Hosp Assoc. 1988;24:495-500 [Google Scholar]
  57. Duthie S,Eckersall PD,Addie DD,Lawrence CE,Jarrett O..Value of alpha 1-acid glycoprotein in the diagnosis of feline infectious peritonitis.Vet Rec. 1997;141:299-303 [DOI] [PubMed] [Google Scholar]
  58. Paltrinieri S,Giordano A,Tranquillo V,Guazetti S..Critical assessment of the diagnostic value of feline alpha 1-acid glycoprotein for feline infectious peritonitis using the likelihood ratios approach.J Vet Diagn Invest. 2007;19:266-72 [DOI] [PubMed] [Google Scholar]
  59. Hirschberger J,Hartmann K,Wilhelm N,Frost J,Lutz H,Kraft W..Clinical symptoms and diagnosis of feline infectious peritonitis.Tierarztl Prax. 1995;23:92-9 [PubMed] [Google Scholar]
  60. Savary KC,Sellon RK,Law JM.Chylous abdominal effusion in a cat with feline infectious peritonitis.J Am Anim Hosp Assoc. 2001;37:35-40 [DOI] [PubMed] [Google Scholar]
  61. Herrewegh AA,Mähler M,Hedrich HJ, et al.Persistence and evolution of feline coronavirus in a closed cat-breeding colony.Virology. 1997;234:349-63 [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Cammarata Parodi M,Cammarata G,Paltrinieri S,Ape F..Using direct immunofluorescence to detect coronaviruses in peritoneal and pleural effusions.J Small Anim Pract. 1993;34:609-13 [Google Scholar]
  63. Tammer R,Evensen O,Lutz H,Reinacher M..Immunohistological demonstration of feline infectious peritonitis virus antigen in paraffin-embedded tissues using feline ascites or murine monoclonal antibodies.Vet Immunol Immunopathol. 1995;49:177-82 [DOI] [PMC free article] [PubMed] [Google Scholar]
  64. Ishida T,Shibanai A,Tanaka S,Uchida K,Mochizuki M..Use of recombinant feline interferon and glucocorticoid in the treatment of feline infectious peritonitis.J Feline Med Surg. 2004;6:107-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Ritz S,Egberink H,Hartmann K..Effect of feline interferon-omega on the survival time and quality of life of cats with feline infectious peritonitis.J Vet Intern Med. 2007;21:1193-97 [DOI] [PMC free article] [PubMed] [Google Scholar]
  66. Hoskins JD,Henk WG,Storz J,Kearney MT.The potential use of a modified live FIPV vaccine to prevent experimental FECV infection.Feline Pract. 1995;23:89-90 [Google Scholar]
  67. McArdle F,Tennant B,Bennett M,Kelly DF,Gaskell RM.Independent evaluation of a modified live FIPV vaccine under experimental conditions (University of Liverpool experience).Feline Pract. 1995;23:67-71 [Google Scholar]
  68. Scott FW,Olsen CW,Corapi WV.Independent evaluation of a modified live FIPV vaccine under experimental conditions (Cornell experience).Feline Pract. 1995;23:74-6 [Google Scholar]
  69. Gerber JD,Ingersoll JD,Gast AM, et al.Protection against feline infectious peritonitis by intranasal inoculation of a temperature-sensitive FIPV vaccine.Vaccine. 1990;8:536-42 [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Postorino Reeves N.Vaccination against naturally occurring FIP in a single large cat shelter.Feline Pract. 1995;23:81-2 [Google Scholar]
  71. Fehr D,Holznagel E,Bolla S, et al.Evaluation of the safety and efficacy of a modified live FIPV vaccine under field conditions.Feline Pract. 1995;23:83-8 [Google Scholar]
  72. Fehr D,Holznagel E,Bolla S, et al.Placebo-controlled evaluation of a modified life virus vaccine against feline infectious peritonitis: Safety and efficacy under field conditions.Vaccine. 1997;15:1101-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  73. Kass PH,Dent TH.The epidemiology of feline infectious peritonitis.Feline Pract. 1995;23:27-32 [Google Scholar]
  74. Cave TA,Thompson H,Reid SWJ,Hodgson DR,Addie DD.Kitten mortality in the United Kingdom: A retrospective analysis of 274 histopathological examinations (1986–2000).Vet Rec. 2002;151:497-501 [DOI] [PubMed] [Google Scholar]
  75. Simons FA,Vennema H,Rofina JE, et al.A mRNA PCR for the diagnosis of feline infectious peritonitis.J Virol Methods. 2005;124:111-16 [DOI] [PMC free article] [PubMed] [Google Scholar]

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