3 CE

CREDITS CE Article

Feline Infectious Peritonitis

❯❯ T eresa L. Goodson, DVM, Abstract: Feline infectious peritonitis (FIP) frequently results in death in cats. It is caused by a
DACVIM (Small Animal mutated, highly contagious coronavirus, and it is more common in indoor cats in multicat house-
Medicine) holds. A complex interaction between the coronavirus and the feline immune system causes
❯❯ S usan C. Randell, BVSc, disseminated vasculitis, which is the hallmark of FIP. New tests are being developed, but the an-
DACVIM (Small Animal
temortem diagnosis of FIP continues to be difficult and frustrating. Current treatments are crude
Medicine)
and involve supportive care and immunosuppression. Minimizing exposure is the best method
❯❯ L isa E. Moore, DVM,
DACVIM (Small Animal of preventing infection.
Medicine)

F
Affiliated Veterinary Specialists eline infectious peritonitis (FIP) is
Maitland, Florida
caused by a mutated coronavirus
and frequently results in death in
cats. The difficulty of establishing the
diagnosis and the lack of effective treat-
ment options have frustrated veterinar-
ians since FIP was identified more than
At a Glance 40 years ago.1 Research is clarifying
the complex pathogenesis of FIP. This
Causative Agents review addresses the pathogenesis and
Page E1
clinical signs of FIP, as well as the cur-
Pathogenesis rent diagnostic tests and management
Page E1
recommendations.
Signalment
Page E2 Causative Agents
Clinical Signs Feline coronavirus is a large, enveloped
Page E2 RNA virus that exists in two forms: feline
Diagnostic Tests enteric coronavirus (FECV) and feline
Page E3 infectious peritonitis virus (FIPV). FECV
is virtually nonpathogenic, whereas FIPV
Treatment
Page E5
is almost invariably fatal.1 All FECV car-
riers have the potential to develop either
Prognosis enteritis or peritonitis, although only
Page E6
about 5% of infections develop into FIP.1
Prevention Currently available diagnostic tests cannot
Page E6
differentiate FECV from FIPV with 100%
accuracy.
Multicat households have a much
higher prevalence of FECV (75% to 100%)
than single-cat households (25%).2–4
Animal shelters and catteries facilitate the
transmission of FECV because of high
environmental stress and sharing of con-
taminated litterboxes.4,5 Increases of up to
a millionfold in fecal shedding of FECV
were seen in FECV-positive cats after
entering an animal shelter.6 Half of the
cats that were originally FECV negative
were shedding FECV within 1 week of
entering the shelter.6
Pathogenesis
FECV, which is highly contagious, is
transmitted primarily via the fecal–oral
route, although it may also be transmitted
by inhalation.1 It replicates in the epithe-
lial cells of the intestinal tract. Fecal shed-
ding begins within 2 days of infection,
and seroconversion occurs within 18 to 21
days after exposure to the virus.1 FECV
replicates only in enterocytes. It can exist
in the systemic circulation but cannot sus-
tain viral production there, so progression
to FIP does not occur.7 However, if a cru-
cial deletion mutation (typically of the 3C
or 7B gene) occurs, the virus can be taken
up by macrophages and gain access to the
systemic circulation, where it transforms
into the highly pathogenic FIPV.8 FIPV
infection is sustained in monocytes and
macrophages, where the virus undergoes
replication and spreads systemically.7
Traditionally, FIP has been divided into
two distinct clinical forms: effusive (wet)
and noneffusive (dry). Approximately three
times as many cats present with the wet
form as with the dry form.9 However,
these divisions are not absolute, as a com-
bination of both forms is often present in
cats with FIP.10 The macrophage is the key
inflammatory cell in both forms of FIP.11
Cats that are infected with FECV but do

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Box 1 TNF-α, IL-6, and IL-12 appear to be associ-
Breed Prevalence of FIP 21 ated with disease progression.15,17–19 The role
of all of these cytokines in the development
of humoral (Th2) and cell-mediated (Th1)
Increased risk No increased risk
immune responses may be instrumental in
Abyssinian Burmese
understanding the pathogenesis of FIP.15,19
Bengal Exotic shorthair
Birman Manx
Himalayan Persian Signalment
Ragdoll Russian blue All felids are susceptible to FIP. Among nondo-
Rex Siamese mestic cats, cheetahs are particularly vulner-
able.20 Among domestic cats, young cats aged
3 months to 3 years and geriatric cats older
not develop FIP are believed to mount a strong than 13 years are most frequently affected.9,12
cell-mediated response, although other, unde- Sexually intact cats, males, and purebred
termined factors are likely involved.1,12 A lack cats have a higher incidence of FIP.9,21,22
of cell-mediated immunity, combined with a Susceptibility to FIP is a polygenic inherited
strong humoral response by the host, leads trait in Persians and Birmans.23 However, a
to the effusive form of FIP.12 Host antibodies recent study revealed differences between
QuickNotes and viral antigens form immune complexes breeds in the prevalence of FIP21 (Box 1).
that are deposited on the vascular endothe-
FIP occurs primar- lium, causing vasculitis with resultant leakage Clinical Signs
ily in indoor cats of proteinaceous fluid. Adhesion of infected FECV infection may manifest as a benign
housed in large monocytes to the endothelium activates com- illness limited to mild diarrhea that rarely
plement, causing the release of vasoactive requires veterinary attention.1 Some cats show
groups.
amines that retract the vascular endothelium, no clinical signs of infection.
allowing further protein and fluid exudation.1 Cats with wet FIP are typically ill and
When virus-infected monocytes enter tissue, debilitated.1,10 Fever or uveitis may be pres-
they attract antibodies that fix complement, ent.1,10 These cats exhibit abdominal disten-
drawing in more macrophages and neutrophils tion, pallor, tachypnea, dyspnea, or muffled
and creating a perivascular pyogranulomatous heart sounds as a result of fluid accumulation
inflammation.1 in the peritoneal or pleural cavities1 (Figure 1).
Experimentally infected monocytes and Pericardial effusion is less common.1 Effusion
macrophages do not express surface viral pro- into body cavities is a nonspecific finding
teins; rather, viral proteins are rapidly inter- without cytologic evaluation of the fluid; simi-
nalized following exposure to FIPV-specific lar effusions occur in a variety of diseases
antibodies. This allows the virus to evade (e.g., lymphoma, hepatic neoplasia, cholang-
antibody-dependent lysis, so the humoral iohepatitis, congestive heart failure, bacterial
response fails to clear FIPV infection.13,14 peritonitis/pleuritis).
If a partial cell-mediated response is mounted, Clinical signs of the dry form can be vague
the noneffusive form of FIP results, and large and nonspecific, including lethargy, poor
pyogranulomas form in many organs.12 The appetite, weight loss, icterus, and an intermit-
vasculitis present in dry FIP is not severe tent fever that does not respond to antibiotics.1
enough to cause the effusion that occurs in Kittens may have stunted growth and diarrhea.
wet FIP.1 Ocular lesions include iritis, uveitis, and cuff-
The patterns of expression of various ing of the retinal vasculature1,24 (Figure 2). Cats
cytokines in the peripheral blood monocytes, with neurologic involvement frequently exhibit
macrophages, lymphoid tissue, and ascitic ataxia, nystagmus, and seizures.25 Abdominal
fluid of cats with FIP are being studied exten- palpation may reveal enlarged lymph nodes
sively. Tumor necrosis factor (TNF)-α, inter- and irregular organ surfaces, especially the
feron (INF)-γ, interleukin (IL)-6, IL-10, and kidneys. Less commonly reported clinical signs
IL-12 appear to play roles in the develop- include intestinal granuloma (often colonic),
ment of FIP.11,15–19 Increases in INF-γ and IL-10 massively enlarged abdominal lymph nodes,
may be protective,11,15,18 whereas increases in orchitis, skin lesions, and pneumonia.1,26–30

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Feline Infectious Peritonitis CE

Diagnostic Tests FIGURE 1

No single sensitive, specific, noninvasive diag­
nostic test for FIP is currently available.
Therefore, test results must be combined with
the history and clinical signs to establish the
diagnosis.
The complete blood cell count (CBC) often
reveals lymphopenia, neutrophilia, nonregen­
erative anemia, and thrombocytopenia. Lympho­
penia is due to virus-induced apoptosis of
lymphoid tissue.31,32 Neutrophilia characterizes
a stress leukogram secondary to infection.10
Nonregenerative anemia is due to chronic
inflammation.10 Thrombocytopenia may be due
to immune-mediated destruction or decreased
bone marrow production of platelets.33
Cat with FIP showing emaciation and abdominal fluid distention.
Hyperglobulinemia is observed in more
than 70% of patients with FIP. Elevated serum
globulin levels may be due to the antibodies FIGURE 2
produced during the host’s humoral immune
response to the virus, as well as the presence
of complement and immune complexes.34,35
Mild hypoalbuminemia may be due to de­-
creased albumin production by the liver or
increased loss from endothelial leakage. The
serum albumin:globulin ratio (A:G) should
be calculated: a value of <0.8 indicates that
the cat likely has FIP (92% positive predic-
tive value [PPV]), whereas a serum A:G >0.8
makes FIP unlikely (61% negative predictive
value [NPV]).10 An elevated bilirubin level is
likely due to liver necrosis. Liver enzyme lev-
els are frequently normal.1 Additional serum
biochemical abnormalities reflect the organs Anterior uveitis due to FIP.
affected by vasculitis and subsequent lack
of blood supply. Disseminated intravascular
coagulopathy and coagulopathies caused by unclear, but the protein may prove to be a
liver necrosis and increased platelet reactivity useful biomarker.37,38 Serum amyloid A (SAA),
can also be seen.36 another acute-phase protein, increases 10-fold
Serum protein electrophoresis may reveal a in the serum of cats with FIP compared with
polyclonal or a monoclonal gammopathy, so healthy cats exposed to FECV.1,38 SAA may also
this test does not help distinguish FIP from other be useful as a biomarker in the future. At this
diseases that cause hyperglobulinemia.10 time, no validated commercial test is available
Alpha-1-acid glycoprotein (AGP) is an acute- for routine evaluation of AGP and SAA levels.
phase protein, the serum level of which is
elevated in many infectious and inflammatory Analysis of Effusion Fluid
diseases. AGP controls lymphocyte produc- FIP effusion fluid is typically a straw-colored,
tion of cytokines by modulating neutrophil modified transudate that contains a high level
and lymphocyte responses. Levels of AGP in of protein (>3.5 g/dL) and few cells (<5000
serum and effusions increase twofold to five- nucleated cells/mL; Figure 3).1 The fluid may
fold in cats with FIP, more than in diseases also be classified as an exudate or, rarely, as
such as neoplasia and cardiomyopathy. The chyle.39 The high protein content comes from
role of AGP in the development of FIP is leakage of globulins across the damaged

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FIGURE 3 a very low PPV for FIP (44%).3 However, a
very high titer (1:1600) has a 94% PPV for FIP.3
A negative titer has a 90% NPV for FIP.3 The
magnitude of the coronavirus titer may be
helpful when evaluated in conjunction with
clinical signs and other test results.3
Viral titers do not always correlate with
fecal shedding of FECV.43 A commercial test
Abdominal effusion fluid removed from a cat with FIP. for the 7B antibody is available, and it initially
showed promise in differentiating FIPV from
FECV. However, additional studies showed the
vascular endothelium. Neutrophils and mac- 7B antibody test to have false positives in some
rophages in the fluid are consistent with pyo- healthy cats with FECV infection. Because this
granulomatous inflammation. test cannot reliably differentiate between FIPV
The A:G ratio of the effusion should be mea- and FECV, it has little diagnostic usefulness.44
sured: a ratio of <0.5 is strongly correlated with Testing for anticoronavirus antibodies in
FIP, with a PPV between 66% and 95%, depend- effusion fluid may be more useful than testing
ing on the prevalence of FIP in the cat’s envi- serum. Detection of anticoronavirus antibodies
ronment.3 An A:G ratio >0.81 has a 100% NPV, in effusion fluid has a PPV of 90% and an NPV
essentially ruling out FIP.1,3,12,40 In some cases, of 79% for the diagnosis of FIP.3 Laboratories
the results of the CBC, serum chemistry, fluid vary widely with regard to reporting anticoro-
analysis, and cytology—combined with a thor- navirus antibody titer results, making interpre-
ough history and physical findings—may be tation very difficult.10 Antibody titers should
QuickNotes sufficient for a presumptive diagnosis of FIP. be interpreted carefully and should never be
Rivalta’s test can be performed to exclude used as the sole test to diagnose FIP.
No single sensitive, FIP as a cause of effusion.3,10 This test has The diagnostic value of anticoronavirus
specific, noninva- an 86% PPV and a 97% NPV for FIP.10 One titers in cerebrospinal fluid (CSF) for the diag-
sive diag­nostic test drop of 98% acetic acid (not vinegar) is mixed nosis of FIP involving the central nervous
for FIP is currently into a test tube containing 5 mL of distilled system (CNS) is questionable. A recent study45
available. water.3,10 One drop of effusion fluid is gently demonstrated anticoronavirus antibodies in
added to the mixture. If the drop dissolves the CSF of cats with neurologic FIP, cats with
and disappears, the result is negative, so FIP FIP not involving the CSF, and cats with brain
can be ruled out as the cause of effusion. If tumors. The cats with positive titers in the CSF
the drop holds its shape due to high levels also had high serum titers. This finding is con-
of protein, fibrin, and inflammatory mediators, sistent with blood contamination of the CSF
the result is positive.41 Diseases other than FIP sample. Detection of anticoronavirus antibod-
that produce positive results on Rivalta’s test ies in the CSF offers no diagnostic advantage
are lymphoma and bacterial peritonitis, which over serum titers, which are of limited value.
can usually be distinguished by cytologic
evaluation of the fluid.10 Rivalta’s test is not Polymerase Chain Reaction
frequently used because 98% acetic acid is not Reverse transcription polymerase chain reac-
readily available in most veterinary practices. tion (RT-PCR) can identify feline coronavirus
in effusion fluid, feces, tissue, or blood.10,42,43,46
Serology Messenger RNA (mRNA) is only present when
Many commercial assays are available to detect the virus is replicating, which is important
anticoronavirus antibodies in serum. However, in differentiating between FIPV and FECV.46
none can distinguish among FECV, other non- Although FECV can be present in the circula-
virulent coronaviruses, and FIPV. Healthy cats tion, it does not replicate within monocytes, so
exposed to nonvirulent coronaviruses (e.g., no mRNA should be identified.46 When FIPV is
canine coronavirus, transmissible gastroen- circulating and replicating within monocytes
teritis virus) will be seropositive. Conversely, and tissue macrophages, it produces mRNA,
cats with fulminant, effusive FIP can be falsely which can be identified using RT-PCR.46 Be­-
seronegative.1,42 A positive titer (all levels) has cause it can be difficult to work with mRNA,

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a DNA copy (cDNA) is created in RT-PCR by
reverse-transcribing the mRNA. The cDNA is
then amplified using primers specific for the
highly conserved M gene so that large quanti-
ties of cDNA are available for identification of
the virus.46 Of cats with confirmed FIP, 93%
tested positive with RT-PCR, and no false posi-
tives occurred in the study group.46
However, RT-PCR results may be incorrect.
False negatives can occur because of degra-
dation by RNases, ubiquitous enzymes that
can easily contaminate a sample. Laboratory
contamination and cross-reaction with other
coronaviruses (e.g., canine coronavirus, trans-
missible gastroenteritis virus) can produce
false-positive results.1
Auburn University’s College of Veterinary
Medicine Molecular Diagnostics Laboratory
is the only laboratory to offer the FIP mRNA
Multi Test. Samples of whole blood, effusion
fluid, and tissue/aspirate of an affected organ
are submitted for RT-PCR testing. The PPV and
NPV of this combined test are both reportedly
close to 100%.47,a
Cerebrospinal Fluid Analysis and Central
Nervous System Imaging
Neurologic abnormalities are present in ap-
proximately 35% of cats with FIP.25,48 CSF
analysis may reveal an elevated protein con-
tent or pleocytosis (lymphocytes and neutro-
phils).10,49,50 FIP should be strongly suspected
in a cat with inflammatory CNS disease and
hydrocephalus identified on magnetic reso-
nance imaging or computed tomography.25,48,51
Histopathology
Histopathology is the gold standard for the
diagnosis of FIP.3,12 Without histopathology,
any diagnosis of FIP is considered presump-
tive. However, cats with FIP are extremely
debilitated, making exploratory surgery for
biopsies risky and impractical. Fine-needle
aspiration and Tru-Cut biopsy of the liver
and kidneys have been evaluated as diagnos-
tic tests for FIP. Lesions consistent with FIP
can be identified using these techniques, and
combining fine-needle aspiration and Tru-Cut
biopsy of the liver has the highest sensitiv-
aMore
information about this test, including pric-
ing and shipping methods, may be obtained at the
Auburn University College of Veterinary Medicine
Web site (www.vetmed.auburn.edu).
CompendiumVet.com | October 2009 | Compendium: Continuing Education for Veterinarians®
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Feline Infectious Peritonitis CE
ity (86%). However, false negatives and inad-
equate samples are common, yielding a very
low diagnostic sensitivity (11% to 38%).52
In many cases, lesions are observed only
at necropsy. The classic lesions are pyogranu-
lomatous inflammation that has caused vascu-
litis, necrosis, and fibrosis.12 The wet form of
FIP affects a large number of blood vessels,
causing the typical effusion, and small plaques
form on the surfaces of abdominal and thoracic
organs. In the dry form, larger pyogranulomas
affect the kidneys, liver, eyes, and CNS.19,50
Solitary mural FIP lesions of the colon or ileo-
cecocolic junction may be grossly mistaken
for neoplasia.26 Meningitis, ependymitis, and
hydrocephalus are seen in the neurologic form
of FIP.25,50 Lymphoid depletion is commonly
observed in the spleen and lymph nodes of
cats that succumb to FIP.32 Lymphoid tissue is
hyperplastic in cats that survive infection.32
QuickNotes
Immunofluorescent staining identifies the The macrophage
coronavirus within macrophages in effusion is the key inflam-
fluid or tissue. This test is 100% specific but matory cell in the
only 50% sensitive for FIP when performed
development of FIP.
on effusion samples.3,10 In other words, FECV
should not be found in macrophages in effu-
sion samples, so a positive result indicates that
the cat has FIP. Low numbers of macrophages
with insufficient virus to create fluorescence
can lead to a false-negative result.10 RT-PCR
can also be performed on tissue that has not
been preserved in formalin.47
Treatment
No curative treatment exists for FIP. Therapy
is directed at suppressing the formation of
immune complexes and thus trying to control
the vasculitis that characterizes the disease.
Supplemental therapies to increase the over-
all well-being of the cat, including fluids and
nutritional support, should be provided.
If an owner or breeder chooses to test
healthy cats, cats identified as FECV seroposi-
tive should not be subjected to stress because
the onset of clinical signs is frequently seen
after events such as elective surgery or intro-
duction to a new home.1 Avoiding stress in
group-housing situations is especially impor-
tant. Cats with diarrhea suspected to be due
to FECV should be managed with supportive
care to maintain hydration, weight, and intes-
tinal bacterial balance.1
Because the immune system of cats with FIP
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is impaired, immunosuppressive therapy may vector (e.g., litterboxes) when housing groups
be contraindicated.53 However, prednisone, of cats. One litterbox should be provided for
intracavitary dexamethasone, and cyclophos- each cat, and the litterboxes should be cleaned
phamide may be used to control the immune daily to reduce fecal contamination.59
response to the virus and temporarily improve Queens should be isolated from all other
the cat’s quality of life.1,10 Ribavirin is an antivi- cats 2 to 3 weeks before delivery. Strict isola-
ral agent with activity against FECV, but its use tion and sanitation should be continued until
is limited by its severe toxicity in cats, which the kittens are weaned at 5 weeks of age. The
causes hemolysis, bone marrow suppression, kittens should be maintained in isolation until
and liver damage.54 they are removed from the cattery. Infected
Various supplements have been used anec- queens can produce kittens negative for FECV
dotally with variable reports of success. High- if the kittens are strictly isolated and weaned
dose injectable human INF-α (104 to 10 6 IU/kg early.60 No cat that produces two or more kit-
SC q24h) inhibits viral nucleic acid and protein tens with FIP should be bred, since a genetic
synthesis. Cats develop neutralizing antibodies predisposition has been shown.21,23
to human INF-α within 3 to 7 weeks, limiting Any cat entering a cattery should be
its usefulness.55 Low-dose oral human INF-α (1 screened with FECV serology or fecal RT-PCR
to 50 IU/kg PO q24h) has immunomodulatory and isolated before introduction to the gen-
QuickNotes effects that may cause progression of FIP and eral cat population.43 Kittens can be screened
is not recommended.56 Feline INF-ω inhibits as young as 10 weeks of age.1 Cats with high
Reverse transcrip- FECV in vitro and is available in some coun- titers, low titers, and negative titers should
tion polymerase tries. A recent report described a small num- be housed separately. As its titer decreases, a
chain reaction is a ber of cats with suspected (not definitively cat can be housed with other nonshedders.2
diagnosed) FIP that were treated with gluco- Chronic shedders should be removed to elimi-
promising test for
corticoids as well as feline INF-ω.57 No well- nate a source of FECV in the cattery. A cat, and
the accurate diag- controlled studies have been performed to ultimately a cattery, may be considered FECV
nosis of FIP. assess the effectiveness of feline INF-ω against negative after 5 consecutive months of nega-
naturally occurring FIP. Propionibacterium acnes tive fecal RT-PCR tests and serology tests.43
is a nonspecific immunostimulant that may
enhance cell-mediated immunity, but no effi- Individual Households
cacy against FIP has been documented.58 An exposed, seropositive, ill cat should be
suspected of having FIP and should be appro-
Prognosis priately evaluated, isolated, and treated. A
Because there is no definitive treatment, the healthy cat that has been exposed to a cat that
prognosis for FIP is grave.59 Cats with the effu- succumbed to FIP should be carefully moni-
sive form of FIP usually survive less than 2 tored for any clinical signs of illness. FECV can
months after presentation and sometimes for remain infectious in the environment for more
only days or weeks.1,12 The clinical signs are than 7 weeks.1 Therefore, an owner should
devastating and rapidly progressive, so eutha- wait at least 3 months before introducing
nasia is justified when the cat has a diminish- another cat into the house.10
ing quality of life.1 The average survival time
for cats with noneffusive FIP is unpredictable, Vaccination
with clinical signs waxing and waning for An intranasal, temperature-sensitive vaccine
weeks to months.1 that stimulates mucosal immunity against
FECV was released in 1991. In field trials, the
Prevention vaccine appeared to be safe and effective
Catteries and Shelters for cats that had not been exposed to FECV
Minimizing exposure is the mainstay of pre- before vaccination.61,62 The efficacy of the vac-
venting the spread of this highly contagious cine is questionable in cats already exposed to
disease. Cats should be housed in groups FECV because mucosal immunity cannot pro-
of five or fewer, with no contact between tect against viral mutation.61,62 Unfortunately,
groups.10 Sanitation is extremely important, most at-risk kittens are already exposed to
and attention should be given to any potential FECV before the vaccine can be administered

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starting at 16 weeks of age. The American
Association of Feline Practitioners lists the FIP
vaccine as “not generally recommended.”63
Conclusion
FIP is a devastating disseminated vasculitis
in cats that results from a complex interac-
tion between a mutated FECV and the feline
immune system. The virus is highly con-
tagious, so the disease is more common in
multicat households and in purebred cats in
catteries. Researchers are continuing to eluci-
date the complex pathophysiology of the dis-
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Feline Infectious Peritonitis CE
ease, which should eventually lead to more
effective methods of prevention and cure.
The recent development of RT-PCR testing QuickNotes
is providing encouraging results for possible
antemortem diagnosis of FIP, although the Minimizing expo-
laboratory providing this test has not pub- sure is the best
lished any information regarding its validation method for preven-
methods. Current treatments are crude at best tion of infection.
and involve supportive care and, sometimes,
blanket suppression of the host’s humoral and
cell-mediated immune responses. Minimizing
exposure is the best method for prevention of
infection.
19. Gunn-Moore DA, Caney SMA, Gruffydd-Jones TJ. Antibody and
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1. Which is the key inflammatory cell in b. mass lesion in the cerebral cortex c. They may be falsely negative in cats
the development of FIP? c. no visible abnormalities with effusive FIP.
a. T cell d. cerebral edema d. all of the above
b. neutrophil
c. macrophage 5. What A:G ratio in effusion fluid is sug- 8. Why are indoor cats more at risk for
d. eosinophil gestive of FIP? developing FIP than outdoor cats?
a. <0.5 a. population density
2. Which breed of cat has a genetic sus- b. 0.6 to 0.8 b. environmental stress
ceptibility for the development of FIP? c. 0.8 to 1.0 c. shared litterboxes
a. Persian d. >1.0 d. all of the above
b. Manx
c. Siamese 6. What histologic lesion is not suggestive 9. What nondomestic feline is most sus-
d. Ragdoll of FIP? ceptible to FIP?
a. perivascular inflammation a. lion
3. What percentage of cats exposed to b. hepatic nodular regeneration b. tiger
FECV develop clinical FIP? c. tissue necrosis c. cheetah
a. <10% d. lymphoid depletion d. cougar
b. 20% to 30%
c. 50% to 60% 7. Why should anticoronavirus titers not be 10. What type of immune response pro-
d. 90% to 100% used to definitively diagnose FIP? duces dry FIP?
a. They cannot distinguish between FIPV a. strong humoral response
4. What finding on brain magnetic reso- and FECV. b. strong cell-mediated response
nance imaging is suggestive of FIP? b. Laboratory reporting of titers is c. partial cell-mediated response
a. hydrocephalus inconsistent. d. INF-γ

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