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FIP Cat
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winnedumah posted:
Here is an update on our six-month-old kitten, Molly. We currently have her on Ringers lactate subcutaneous (50-75) per day and Hills A/D. She eats some on her own and we feed her the rest. The following is what the blood work indicated. I am only posting the positive results. These are the markers that led our vet to believe that Molly has FIP.

Her total Globulin protein is 9.2
Amylase is high at 1748
Platelet count is low at 141
Positive for FCV IFA at 1:400
Protein 2+ (High)
Occult Blood 3+ (High)
RBC >50 (High)
Positive for Giardia

We are hoping for some improvement. Any advise is greatly appreciated. I will keep you updated.

Winn
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srstephanie responded:
Hi winnedumah,

You will need a vet response to this because it is getting way beyond my very limited knowledge.

I think one thing that sometimes "points" to FIP is a high total protein/globulin combined with a low albumin. You don't say what the Albumin level is. I live in Canada which uses metric, so the numbers are often unfamiliar to me. Also, individual labs can have differences in their "normal range". It can help if you put the lab's normal range after the value of your cat.

I'm guessing that the FCV IFA is the Coronavirus titer. As I've mentioned before, that doesn't mean anything other than that the cat has been exposed to the benign enteric coronavirus. A high titer may keep the diagnosis of FIP higher on the differential list (though a low titer doesn't exclude FIP). I think a 1:400 is considered rather low, but I'm no expert on that.

You say you are giving subcutaneous fluids. That suggests that your vet considers her dehydrated. If the blood for the blood test was drawn while she was dehydrated, that can increase some of the values, like the blood counts.

It is interesting that she is positive for Giardia. I assume the vet doesn't feel that is responsible for her symptoms, and isn't worth treating now? Giardia is an intestinal parasite.

That pretty much exhausts what little a "think" I may know. A vet will have to interpret the values for you. But while some blood values can "point" to FIP ... I don't think the experts believe they are diagnostic to the point of confirming FIP ... particularly if it is the dry form and there is no fluid in the belly or chest.

I will say a prayer for Molly and hope it isn't FIP. The supportive care of fluids and food are probably good (assuming she is dehydrated). If your vet feels it is FIP, maybe you can ask him/her about giving steroids, etc?

Let us know how things turn out.

Stephanie in Montreal
 
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winnedumah replied to srstephanie's response:
Hi Stephanie,

Molly's Albumin level is 2.50 (normal is 2.50 to 3.90). The vet stated on the phone that Molly's stool was normal, but the printout states positive for Giardia. I don't believe that she feels there is a point in treating it under the circumstances. She believes that we should euthanize her. The vet states the disease is fatal and we are wasting our time.

Molly is dehydrated, so we are giving her fluids at home. I agree that blood tests can be misleading. FIP can cause a loss of potassium, so as of today we are administering that. Also Moducare to boost her immune system.

That's it for now.
Winn
 
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srstephanie replied to winnedumah's response:
Hi winnedumah,

Seems like a long time since I've seen any vets responding to questions here. Guess they are all very busy.

I don't have the knowledge to interpret the lab values, though your vet may be right that they point to FIP. You probably have to decide whether you want to spend the money on further diagnositics (perhaps seeing an Internist). If it is FIP, your vet is right that it is considered universally fatal.

If you don't want to pursue more definitive diagnostics, something that may help you decide when it may be time for euthanasia is the "Quality of Life Scale" that was developed by a veterinary Oncologist a few years ago to help give some objectivity to deciding when it is time. It is sometimes called the "HHHHHMM Scale" which stands for:
Hurt
Hunger
Hydration
Hygiene
Happiness
Mobility
More Good Days Than Bad

For each area, a score is given from 1-10 (1 is worst, 10 best). If the total of the scores is greater than 35, then it suggests that the pet still has a satisfactory quality of life.

The scale is found in multiple places on the internet. Here is one which gives summaries for each area of what to look for, and there is a link to a pdf version above the scale on the webpage:
http://www.veterinarypracticenews.com/vet-practice-news-columns/bond-beyond/quality-of-life-scale.aspx

I hope one of the vets here will give you some guidance. FIP is such a terrible disease, yet it is so difficult to diagnose that one hates to give up too quickly. There have been many cats euthanized for FIP who did not turn out to have it. Someone I know just had that happen with a necropsy showing that the cat didn't have FIP ... but did have severe deformity of its kidneys, so euthanasia was probably the right thing to do anyway. Ultimately, I guess you have to look at the quality of life and try to do what you think is best for your kitty.

I hope you get a vet response soon.

You and Molly are in my prayers. Let us know how things go.

Stephanie in Montreal

PS: Just noticed Dr Draper is answering some questions now. Perhaps he will reply to you.
 
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srstephanie replied to winnedumah's response:
Hi Winn,

I was just re-reading your last post and noticed you say you are giving her something to boost her immune system. Have you asked your vet about that?

Maybe my memory is faulty, but I recall listening to vet continuing education talks in which it was said that FIP is NOT a result of a suppressed immune response, but rather is a HYPER or over-response of the immune system. In the efforts of the immune system to respond to the FIP virus, it ends up attacking the body and destroying good cells. I recall that vets tend to give steroids in an effort to suppress the immune system and slow down the progression of the disease.

I may be wrong on that, but maybe you should check with your vet ... or one of the vets here will respond.

Take care,
Stephanie in Montreal
 
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winnedumah replied to srstephanie's response:
Hi Stephanie,

Molly passed away on Monday. She will be cremated and travel to Yosemite National Park this summer to live in heaven. She had a tough life, but fought until the end. We will always love her.
G
 
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srstephanie replied to winnedumah's response:
Hi winnedumah,

I'm so very sorry to hear about Molly. Knowing how hard it is to diagnose FIP, I was still hoping it might be something else. It is such a horrible disease ... and always seems to strike the best and most loving kitties.

Molly's life was too short but she was blessed to have found you and to have been surrounded by your love. You made her short life a happy one. She has touched our lives as well ... and will always live in your heart.

I will make a donation in Molly's memory to the Winn Feline Foundation Bria Fund (for FIP research).

Take care,
Stephanie in Montreal


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