f eline i nfectious p eritonitis
DESCRIPTION
F eline I nfectious P eritonitis. Accession #137373 Christina Copple, DVM. “Fiver”, 5mth old, Male, Singapura. Clinical Complaint: Chronic inappetance with acute onset anorexia, vomited once? PE abnormalities: Decreased to absent lung sounds Prominent LNs on palpation - PowerPoint PPT PresentationTRANSCRIPT
FELINE INFECTIOUS PERITONITISAccession #137373
Christina Copple, DVM
“FIVER”, 5MTH OLD, MALE, SINGAPURA Clinical Complaint: Chronic
inappetance with acute onset anorexia, vomited once?
PE abnormalities: Decreased to absent lung
sounds Prominent LNs on palpation Abdomen distended, palpable
fluid wave Fast US in ER: moderate
peritoneal & pleural effusion
“HE’S GOT FLUID” Thoracocentesis & Abdominocentesis
yellow, viscous fluid TP = 4.8 Modified transudate with disproportionate
increase in protein + Rivalta precipitates = more consistent with
exudate
Peritoneal Fluid
UB
Medullary Rim Sign
Peritonitis & Functional Ileus
FELINE INFECTIOUS PERITONITIS Mutated Feline Enteric Coronavirus Risk Factors:
Mutlicat household or cattery Purebred - cattery Sexually intact Young to middle aged (<5yrs)
Higher incidence (75%) in males 2 Forms:
Effusive Noneffusive
EFFUSIVE FORM ----- FIVER Immune-mediated vasculitis
Activated macrophages which contain actively replicating FIP virus
Loss of protein-rich fluid: peritoneal effusion, pleural effusion or pericardial effusion Subcapsular space of kidneys Effusion – high-protein, moderately cellular ==
modified transudate
NONEFFUSIVE FORM Pyogranulomatous or Granulomatous
Inflammation Multiple organs affected
Eyes Brain Kidney Omentum Focal intestinal lesions
ABDOMINAL ULTRASONOGRAPHIC FINDINGS ASSOCIATED WITH FELINE
INFECTIOUS PERITONITIS: A RETROSPECTIVE REVIEW OF 16 CASES
13 had necropsy, remaining 3 were combo of histo, cyto, and clinpath findings highly suggestive of FIP
Normal US does not exclude possibility of FIP No US findings were specific or sensitive for
hepatic or splenic changes associated with FIP Liver: normal in 11 (69%), diffusely hypoechoic in 3
(19%), focally hyperechoic in 1 (0.6%) and focally hypoechoic in 1 (0.6%)
Spleen: normal in 14 (88%), hypoechoic in 2 (1.2%)JAAHA 2010;46:152-160
ABDOMINAL ULTRASONOGRAPHIC FINDINGS ASSOCIATED WITH FELINE
INFECTIOUS PERITONITIS: A RETROSPECTIVE REVIEW OF 16 CASES
With appropriate clinical signs and a combination of the following findings, the index of suspicion for FIP should increase Renomegaly Irregular renal contour & hypoechoic subcapsular
echogenicity Abdominal lymphadenopathy Peritoneal or retroperitoneal effusion Diffuse changes within intestines
JAAHA 2010;46:152-160
JAAHA 2010;46:152-160
Figure 1—Transverse ultrasound image of a left kidneyshowing irregular renal margins, hypoechoic subcapsularinfiltration (white arrows), and mottled echogenicity.
Figure 2—Ultrasound image of a right kidney demonstrating mottled renal echogenicity, hypoechoic subcapsular infiltration (white arrows), and decreased corticomedullary definition. Both kidneys were subjectively enlarged.
ABDOMINAL ULTRASONOGRAPHIC FINDINGS ASSOCIATED WITH FELINE
INFECTIOUS PERITONITIS: A RETROSPECTIVE REVIEW OF 16 CASES
Pyogranulomatous or granulomatous hepatitis, nephritis, or pleuritis
Pleural & peritoneal effusion Pyogranulomatous orchitis Pyogranulomatous enteritis
Diffuse intestinal involvement more than solitary lesions 3 (19%) intestinal thickening
More often small intestine vs large intestine 1 - diffuse small intestinal thickening 1 - duodenal thickening 1 – colonic thickening with loss of layering JAAHA 2010;46:152-160