FIP Pics!

JFMS 2023

January 22, 2025

Thiago R Müller, Dominique G Penninck, Cynthia Rl Webster, Francisco O Conrado

Background
Feline infectious peritonitis (FIP), caused by a mutant form of feline enteric coronavirus, presents in effusive and non-effusive forms and is systemic in nature. Historically fatal, recent advances in antiviral treatments underscore the importance of early diagnosis. The study aimed to describe abdominal ultrasonographic (US) findings in cats with confirmed or presumed FIP, expanding on previous reports of associated lesions.

Methods
This retrospective study reviewed cases from an academic veterinary hospital database (2013–2022). Inclusion criteria encompassed cats with confirmed or highly suspected FIP based on clinical presentation, laboratory results, and histopathological or molecular evidence. Abdominal US findings were analyzed, documenting abnormalities in effusion, lymph nodes, liver, gastrointestinal (GI) tract, spleen, kidneys, and other structures. Descriptive statistics summarized the data.

Results
Study Population: 25 cats were included; 12 had definitive diagnoses via immunohistochemistry (IHC) or RT-PCR, and 13 were highly suspicious for FIP.


Common Findings:
Abdominal effusion: Present in 88% of cases.


Lymphadenopathy: Observed in 80%, with enlarged and hypoechoic lymph nodes.


Liver abnormalities: Found in 80%, including hepatomegaly (52%) and hypoechogenicity (48%).


GI tract involvement: 68% showed abnormalities, with ileocecocolic junction and colonic changes being most prevalent (52%).


Splenic and renal changes: Detected in 36% and 32% of cats, respectively, including splenomegaly and subcapsular hypoechoic rims.


Mesenteric and peritoneal abnormalities: Present in 28% and 16%, respectively.
Most cats (92%) exhibited abnormalities in multiple abdominal sites.


Limitations
The study was limited by:

Small sample size and reliance on retrospective data.
Variability in ultrasonographic equipment and operator experience.
Lack of histopathological confirmation for all ultrasonographic findings.


Conclusions
The study demonstrated a high prevalence of multisystemic ultrasonographic abnormalities in cats with FIP, particularly effusion, lymph node, hepatic, and GI tract changes. While the findings are non-specific, their combination aids in prioritizing FIP in differential diagnoses. US imaging is valuable for fluid sampling and monitoring treatment responses. Further prospective, multi-institutional studies are recommended to enhance diagnostic correlations.

Parasagittal ultrasound image of the right kidney in an 8-month-old cat with feline infectious peritonitis (case 19) showing a 1 cm hyperechoic cortical nodule (cursors). There is concurrent retroperitoneal anechoic effusion (asterisks). (b) Pyogranulomatous nephritis in a 1-year-old cat with feline infectious peritonitis (case 18). Longitudinal ultrasound image of the enlarged (4.7 cm long) right kidney with heterogeneous parenchyma and slightly irregular margination. A thin hypoechoic rim is also noted at the outer cortical (white arrow). The perirenal fat is hyperechoic. The asterisk indicates a scant amount of urine in the renal pelvis. Pyogranulomatous nephritis was diagnosed on necropsy

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