Abdominal ultrasonographic findings of cats with feline infectious peritonitis: an update

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

Background: Feline infectious peritonitis (FIP) is a systemic viral disease that affects young cats and has a high mortality rate. Abdominal ultrasound can help identify lesions in various organs and guide diagnostic sampling.

Study: This was a retrospective study of 25 cats with confirmed or presumed FIP that underwent abdominal ultrasound at an academic veterinary hospital. The aim was to describe the ultrasonographic findings and their correlation with clinical, laboratory and histopathologic data.

Methods: The diagnosis of FIP was based on history, clinical presentation, laboratory tests, fluid analysis, molecular testing, cytology and/or histopathology. Abdominal ultrasound was performed by different operators and reviewed by a board-certified radiologist and a resident. The presence and characteristics of effusion, mesentery, peritoneum, lymph nodes, liver, gastrointestinal tract, spleen and kidneys were recorded and analyzed.

Results: All 25 cats had ultrasonographic abnormalities, with effusion being the most common finding (88%). Lymphadenopathy (80%), hepatic changes (80%) and intestinal changes (68%) were also frequent. Most cats had two or more locations of abdominal abnormalities. The most common intestinal lesions were ileocecocolic junction and/or colonic wall thickening with altered to lost layering. Histopathology confirmed pyogranulomatous inflammation and vasculitis in affected organs. Two cats treated with a novel antiviral therapy showed improvement of clinical signs and resolution of some ultrasonographic lesions.

Limitations: The study had some limitations, such as the lack of a gold standard diagnosis in some cats, the inconsistency in ultrasonographic examinations and reporting, the lack of histopathologic or cytologic correlation for all lesions, and the small sample size.

Conclusions: The study documented a wider range and distribution of ultrasonographic lesions in cats with FIP than previously reported. The presence of effusion and involvement of several organs, along with the signalment, history, clinical signs and clinicopathologic data, can support the diagnosis of FIP. Ultrasound can also facilitate the sampling of fluid and/or affected organs for definitive diagnosis and monitor the response to treatment.

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