Title: Feline infectious peritonitis

{{Short description|Highly deadly disease that affects cats}}
{{Use DMY dates|date=October 2023}}
{{Infobox medical condition (new)
| name       = Feline infectious peritonitis
| image      = FIPHisto1.jpg
| caption    = FIP-infected kidney showing inflammatory response
| causes     = Mutation of [[feline coronavirus]]
| duration   = 1-month or less average life expectancy after diagnosis, especially in kittens
| symptoms   = Initial phase: [[common cold]]-like symptoms.
Later on: [[ataxia]], [[muscle weakness]], [[dysphagia]].
End phase: [[shortness of breath]], [[urinary incontinence]], [[paralysis]].
| onset      = Can take up to a year for symptoms to appear after exposure to virus
| prevention = 
| treatment  = UK, Australia, Netherlands: [[GS-441524]] (given orally as tablets) and its parent drug [[remdesivir]] (given by intravenous or subcutaneous injection)&lt;ref&gt;Hartmann 2017. Coronavirus Infections (Canine and Feline), Including Feline Infectious Peritonitis. Chapter 224 p984–991. In Textbook of Internal Medicine, 4th Edition. Ettinger.&lt;/ref&gt;&lt;ref&gt;Kennedy and Little 2012. Infectious diseases, Chapter 33 p1038–1047. In The Cat. Clinical Medicine and Management, Little.&lt;/ref&gt;&lt;ref&gt;Pederson et al 2019. Efficacy and safety of the nucleoside analog GS-441524 for treatment of cats with naturally occurring feline infectious peritonitis. J Feline Med Surg.21: 271–281&lt;/ref&gt;&lt;ref&gt;Dickinson et al 2020. Antiviral treatment using the adenosine nucleoside analogue GS‐441524 in cats with clinically diagnosed neurological feline infectious peritonitis J Vet Intern Med. 2020 Jul; 34(4): 1587–1593&lt;/ref&gt;
| prognosis  = Usually fatal without treatment, but with GS-441524 treatment over 80% of treated cats make a full recovery.
| frequency  = Common
}}
'''Feline infectious peritonitis''' ('''FIP''') is a common and aberrant immune response in [[cat]]s to infection with [[feline coronavirus]] (FCoV).&lt;ref&gt;{{cite journal |last1=Addie |first1=D. |last2=Belák |first2=S. |last3=Boucraut-Baralon |first3=C. |last4=Egberink |first4=H. |last5=Frymus |first5=T. |last6=Gruffydd-Jones |first6=T. |last7=Hartmann |first7=K. |last8=Hosie |first8=M. J. |last9=Lloret |first9=A. |title=Feline infectious peritonitis. ABCD guidelines on prevention and management |journal=Journal of Feline Medicine and Surgery |date=11 July 2009 |volume=11 |issue=7 |pages=594–604 |doi=10.1016/j.jfms.2009.05.008 |pmid=19481039 |pmc=7129471}}&lt;/ref&gt;

== The virus and pathogenesis of FIP ==
FCoV is a virus of the gastrointestinal tract. Most infections are either asymptomatic or cause diarrhea, especially in kittens, as maternally derived antibody wanes at between 5 and 7 weeks of age. The virus is a mutation of feline [[enteric]] coronavirus (FECV). From the gut, the virus very briefly undergoes a [[Systemic disease|systemic]] phase,&lt;ref&gt;{{cite journal |last1=Porter |first1=E. |last2=Tasker |first2=S. |last3=Day |first3=M. J. |last4=Harley |first4=R. |last5=Kipar |first5=A. |last6=Siddell |first6=S. G. |last7=Helps |first7=C. R. |date=25 April 2014 |title=Amino acid changes in the spike protein of feline coronavirus correlate with systemic spread of virus from the intestine and not with feline infectious peritonitis |journal=Veterinary Research |publisher=BiomedCentral |volume=45 |issue=1 |pages=49 |doi=10.1186/1297-9716-45-49 |pmid=24767677 |pmc=4006447 |doi-access=free }}&lt;/ref&gt; before returning to the gut where it is shed in the feces.

The [[pathogenesis]] of FIP is complex. There is a general consensus that FIPVs arise from mutations enabling them to enter or replicate more successfully in [[monocyte]]s (a type of white blood cell). However, many aspects of virus–host interactions affecting the disease remain uncertain, such as the factors that influence disease form (wet or dry), outcome (death or resistance), and host susceptibility.&lt;ref&gt;{{cite journal |last=Pedersen |first=N. C. |title=An update on feline infectious peritonitis: Virology and immunopathogenesis |journal=The Veterinary Journal |date=August 2014 |volume=201 |issue=2 |pages=123–132|doi=10.1016/j.tvjl.2014.04.017 |pmid=24837550 |pmc=7110662}}&lt;/ref&gt;

== Virus and disease transmission ==
There is a lack of evidence that FIP as such is transmissible from cat to cat, although it may explain rare mini-outbreaks of FIP.&lt;ref&gt;{{cite journal |doi=10.1016/j.tvjl.2014.04.017|title=An update on feline infectious peritonitis: Virology and immunopathogenesis |date=2014 |last1=Pedersen |first1=Niels C. |journal=The Veterinary Journal |volume=201 |issue=2 |pmid=24837550 |pmc=7110662 |at=Transmission of feline infectious peritonitis virus |s2cid=23453920}}&lt;/ref&gt; However, the virus, FCov, is transmissible from cat to cat.

A study on 59 FIP infected cats found that, unlike FCoV, feces from FIP infected cats were not infectious to laboratory cats via oronasal route.&lt;ref&gt;{{cite journal |doi=10.1016/j.virusres.2011.12.020 |title=Feline infectious peritonitis: Role of the feline coronavirus 3c gene in intestinal tropism and pathogenicity based upon isolates from resident and adopted shelter cats |date=2012 |last1=Pedersen |first1=Niels C. |last2=Liu |first2=Hongwei |last3=Scarlett |first3=Jennifer |last4=Leutenegger |first4=Christian M. |last5=Golovko |first5=Lyudmila |last6=Kennedy |first6=Heather |last7=Kamal |first7=Farina Mustaffa |journal=Virus Research |volume=165 |issue=1 |at=4.2. Role of the 3c gene of FECVs and FIPVs in intestinal tropism and fecal shedding |pmid=22280883 |pmc=7114484}}&lt;/ref&gt; FCoV is common in places where large groups of cats are housed together indoors (such as breeding [[cattery|catteries]], [[animal shelter]]s, etc.). The virus is shed in feces, and cats become infected by ingesting or inhaling the virus, usually by sharing [[cat litter]] trays, or by the use of contaminated litter scoops or brushes transmitting infected microscopic cat litter particles to uninfected kittens and cats.&lt;ref&gt;{{Cite web |url= https://www.youtube.com/watch?v=rkqUjeQNEQs |archive-url= https://ghostarchive.org/varchive/youtube/20211221/rkqUjeQNEQs |archive-date=21 December 2021 |url-status= live |title= How cats become infected with feline coronavirus: animation |date= 18 August 2011 |via= YouTube}}{{cbignore}}&lt;/ref&gt; FCoV can also be transmitted through different bodily fluids. The virus is easily spread through direct contact between cats. The most common form of spreading is through saliva, as most multiple cat homes share food and water dishes.&lt;ref&gt;{{Cite web |url= http://www.healthcommunities.com/feline-infectious-peritonitis/transmission.shtml |title= Feline Infectious Peritonitis (FIP) Transmission – Feline Infectious Peritonitis (FIP) |website= HealthCommunities |access-date=2 November 2018}}&lt;/ref&gt; Another major form of spreading is grooming or fighting. When an infected cat grooms a healthy cat, it leaves its contaminated saliva on the fur. Later, when the healthy cat goes to groom themselves, it ingests the contaminated saliva and then becomes infected.&lt;ref&gt;{{Cite news |url= https://catfriendly.com/feline-diseases/fip/ |title=FIP |work=The Cat Community |access-date=2 November 2018}}&lt;/ref&gt;

==Clinical signs==
&lt;!-- Image with unknown copyright status removed: [[Image:Marked ascites.jpg|thumb|right|A cat with marked ascites (accumulation of fluid in the abdomen), a hallmark sign of FIP]] --&gt;
[[Image:Pleural effusion from a cat with feline infectious peritonitis.jpg|thumb|FIP effusive fluid]]

There are two main forms of FIP: [[effusive]] (wet) and non-effusive (dry). While both types are fatal, the effusive form is more common (60–70% of all cases) and progresses more rapidly than the non-effusive form.{{cn|date=November 2022}}

===Effusive (wet) FIP===
The hallmark [[clinical sign]] of effusive FIP is the [[Ascites|accumulation of fluid within the abdomen]] [[Pleural effusion|or chest]], which can cause breathing difficulties. Other symptoms include lack of appetite, fever, weight loss, [[jaundice]], and diarrhea.{{cn|date=November 2022}}

===Non-effusive (dry) FIP===
Dry FIP will also present with lack of appetite, fever, jaundice, diarrhea, and weight loss, but there will not be an accumulation of fluid. Typically a cat with dry FIP will show [[eye|ocular]] or [[neurology|neurological]] signs. For example, the cat may develop difficulty in standing up or walking, becoming functionally paralyzed over time. Loss of vision is another possible outcome of the disease.{{cn|date=November 2022}}

==Diagnosis==
[[Image:FIPCytology2.jpg|thumb|right|Cytology of FIP-induced fluid showing [[neutrophil]]s, [[macrophage]]s and [[lymphocyte]]s]]

===Diagnosing effusive FIP===
Diagnosis of the effusive form of the disease has become more straightforward in recent years. Detection of viral RNA in a sample of the effusion (liquid drained from body), such as by [[reverse transcription polymerase chain reaction]] (RT-PCR) is diagnostic of effusive FIP.&lt;ref&gt;{{cite journal |last1=Felten |first1=S. |last2=Leutenegger |first2=C. M. |last3=Balzer |first3=H-J |last4=Pantchev |first4=N. |last5=Matiasek |first5=K. |last6=Wess |first6=G. |last7=Egberink |first7=H. |last8=Hartmann |first8=K. |title=Sensitivity and specificity of a real-time reverse transcriptase polymerase chain reaction detecting feline coronavirus mutations in effusion and serum/plasma of cats to diagnose feline infectious peritonitis |publisher=BiomedCentral |journal=Veterinary Research |date=2 August 2017 |volume=13 |issue=1 |page=228 |doi=10.1186/s12917-017-1147-8 |pmid=28768514 |pmc=5541694 |doi-access=free }}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Doenges |first1=S. J. |last2=Weber |first2=K. |last3=Dorsch |first3=R. |last4=Fux |first4=R. |last5=Hartmann |first5=K. |s2cid=7136727 |title=Comparison of real-time reverse transcriptase polymerase chain reaction of peripheral blood mononuclear cells, serum and cell-free body cavity effusion for the diagnosis of feline infectious peritonitis |journal=Journal of Feline Medicine and Surgery |date=1 April 2017 |volume=19 |issue=4 |pages=344–350 |doi=10.1177/1098612X15625354 |pmid=26787293 |pmc=11119647 |url=https://epub.ub.uni-muenchen.de/53028/1/1098612x15625354.pdf}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Longstaff |first1=L. |last2=Porter |first2=E. |last3=Crossley |first3=V. J. |last4=Hayhow |first4=S. E. |last5=Helps |first5=C. R. |last6=Tasker |first6=S. |s2cid=206692877 |title=Feline coronavirus quantitative reverse transcriptase polymerase chain reaction on effusion samples in cats with and without feline infectious peritonitis |journal=Journal of Feline Medicine and Surgery |date=16 October 2015 |volume=19 |issue=2 |pages=240–245 |doi=10.1177/1098612X15606957 |pmid=26474594 |doi-access=free|pmc=10816577 |hdl=1983/2cba7130-9b6c-405f-9a47-276b7a09ed1d |hdl-access=free }}&lt;/ref&gt; However, that does require that a sample be sent to an external veterinary laboratory. Within the veterinary hospital there are a number of tests which can rule out a diagnosis of effusive FIP within minutes:
# Measure the total protein in the effusion: if it is less than 35&amp;nbsp;g/L, FIP is extremely unlikely.
# Measure the [[albumin]] to [[globulin]] ratio in the effusion: if it is over 0.8, FIP is ruled out; if it is less than 0.4, FIP is a possible—but not certain—diagnosis.&lt;ref name=&quot;auto&quot;&gt;{{Cite web |url=http://www.catvirus.com/WhatIsFIP.htm#Diagnosis+of+FIP |title=Dr. Addie – What is FIP? |website=CatVirus.com}}&lt;/ref&gt;
# Examine the cells in the effusion: if they are predominantly [[lymphocytes]] (a type of white blood cell), then FIP is excluded as a diagnosis.

===Diagnosing non-effusive FIP===
Non-effusive FIP is more difficult to diagnose than effusive FIP because the clinical signs tend to be more vague and varied: the list of [[Differential diagnosis|differential diagnoses]] is therefore much longer. Non-effusive FIP diagnosis should be considered when the following criteria are met:&lt;ref name=&quot;auto&quot;/&gt;
# History: the cat is young (under 2 years old) and purebred: over 70% of cases of FIP are in pedigree kittens.{{cn|reason=Cannot find study for that number, only that they are overrepresented but not necessarily the majority of cases|date=January 2024}}
# History: the cat experienced stress such as recent neutering or vaccination&lt;ref&gt;{{cite journal |last1=Riemer |first1=F. |last2=Kuehner |first2=K. A. |last3=Ritz |first3=S. |last4=Sauter-Louis |first4=C. |last5=Hartmann |first5=K. |s2cid=206692653 |title=Clinical and laboratory features of cats with feline infectious peritonitis: A retrospective study of 231 confirmed cases (2000–2010) |journal=Journal of Feline Medicine and Surgery |date=16 July 2015 |volume=18 |issue=4 |pages=348–356 |doi=10.1177/1098612X15586209 |pmid=26185109|url=https://epub.ub.uni-muenchen.de/46869/|doi-access=free |pmc=11112253 }}&lt;/ref&gt;
# History: the cat had an opportunity to become infected with FCoV, such as originating in a breeding or rescue cattery, or the recent introduction of a purebred kitten or cat into the household.
# Clinical signs: the cat has become [[Anorexia (symptom)|anorexic]] or is eating less than usual; has lost weight or failed to gain weight; has a [[fever of unknown origin]]; intra-ocular signs; jaundice.&lt;ref&gt;{{cite book |first=Diane D. |last=Addie |title=Feline Infectious Peritonitis and Coronavirus: Everything a cat lover needs to know |date=19 April 2013 |publisher=CreateSpace Independent Publishing Platform |isbn=9781480208971}}&lt;/ref&gt;
# Biochemistry: [[hypergammaglobulinaemia]]; raised [[bilirubin]] without liver enzymes being raised.
# [[Hematology]]: [[lymphopenia]]; non-regenerative—usually mild—[[anaemia]].
# [[Serology]]: the cat has a high antibody [[titre]] to FCoV: this parameter should be used with caution, because of the high prevalence of FCoV in breeding and rescue catteries.

Non-effusive FIP can be ruled out as a diagnosis if the cat is [[Serostatus|seronegative]], provided the antibody test has excellent sensitivity. In a study which compared various commercially available in-house FCoV antibody tests,&lt;ref&gt;{{cite journal |last1=Addie |first1=D. D. |last2=le Poder |first2=S. |last3=Burr |first3=P. |last4=Decaro |first4=N. |last5=Graham |first5=E. |last6=Hofmann-Lehmann |first6=R. |last7=Jarrett |first7=O. |last8=McDonald |first8=M. |last9=Meli |first9=M. L. |s2cid=21831168 |title=Utility of feline coronavirus antibody tests |journal=Journal of Feline Medicine and Surgery |date=1 February 2015 |volume=17 |issue=2 |pages=152–162 |doi=10.1177/1098612X14538873 |pmid=24966245 |doi-access=free|pmc=10816424 |hdl=11586/146443 |hdl-access=free }}&lt;/ref&gt; the FCoV Immunocomb (Biogal) was 100% sensitive; the Speed F-Corona rapid [[immunochromatographic]] (RIM) test (Virbac) was 92.4% sensitive and the FASTest feline infectious peritonitis (MegaCor Diagnostik) RIM test was 84.6% sensitive.

==Treatment==
[[File:FIP kitten.jpg|thumb|Eight-month-old kitten in end stage &quot;dry&quot; FIP, who had signs of anemia, lethargy, and weight loss. She exhibited eye changes (widening and paralysis of pupils) during seizures.]]
Because FIP is an [[immune-mediated disease]], treatment falls into two categories: direct action against the virus itself and modulation of the immune response.

=== Antiviral drugs ===
[[Antiviral]]s (in the narrow sense) act by interfering with the enzymes or other biological processes in the FIP virus.

====GS-441524 and remdesivir====
{{See also|GS-441524|Remdesivir}}

An experimental drug called [[GS-441524]] was used in a [[field experiment]] of 31 cats. After 25 days, five cats had died, eight had been cured and subsequently relapsed, and 18 had been cured without any subsequent relapses. The eight who relapsed were treated again, some with higher doses. Of these eight, one died and seven were cured, meaning that 25 of the 31 cats were ultimately cured of FIP. This study is considered very promising.&lt;ref&gt;{{cite journal |last1=Pedersen |first1=N. C. |last2=Perron |first2=M. |last3=Bannasch |first3=M. |last4=Montgomery |first4=E. |last5=Murakami |first5=E. |last6=Liepnieks |first6=M. |last7=Liu |first7=H. |date=13 February 2019 |title=Efficacy and safety of the nucleoside analog GS-441524 for treatment of cats with naturally occurring feline infectious peritonitis |journal=Journal of Feline Medicine and Surgery |volume=21 |issue=4 |pages=271–281 |doi=10.1177/1098612X19825701 |pmid=30755068 |pmc=6435921}}&lt;/ref&gt;

In 2024, GS-441524 became commercially available in the U.S. through at least one compounding pharmacy.&lt;ref&gt;{{Cite web |title=FIP treatment GS-441524 – now available in the U.S. {{!}} Cornell University College of Veterinary Medicine |url=https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/fip-treatment-gs-441524-now-available-us |access-date=2025-03-27 |website=www.vet.cornell.edu |language=en}}&lt;/ref&gt; Previously, the FDA allowed its usage under certain conditions.&lt;ref&gt;{{cite web |date=10 May 2024 |title=FDA Announces Position on Use of Compounded GS-441524 to Treat FIP |url=https://www.fda.gov/animal-veterinary/cvm-updates/fda-announces-position-use-compounded-gs-441524-treat-fip |work=FDA}}&lt;/ref&gt;

In several countries oral GS-441524 tablets (and its injectable prodrug [[remdesivir]]) became legally available to vets for the treatment of FIP in cats, for example in Australia,&lt;ref name=&quot;:0&quot;&gt;{{Cite web |title=Feline Infectious Peritonitis (FIP) |url=https://icatcare.org/advice/feline-infectious-peritonitis-fip/ |access-date=15 October 2023 |website=icatcare.org |publisher=International Cat Care}}&lt;/ref&gt; the Netherlands,&lt;ref&gt;{{Cite web |title=Nu ook in Nederland behandeling voor katten met FIP |url=https://www.licg.nl/nieuws/nu-ook-in-nederland-behandeling-voor-katten-met-fip/ |access-date=15 October 2023 |website=LICG.nl |publisher=Landelijk InformatieCentrum Gezelschapsdieren |language=nl}}&lt;/ref&gt;{{Efn|At the moment, legal treatment with GS-441524 in the Netherlands is only available through vets from the Veterinary medicine department of [[Utrecht University]]. The drug is made in the University pharmacy. After a successful trial period starting in June 2023, the drug will become legally available for FIP treatment in cats to all vets in the country. Remdesivir can be legally used for treatment by all vets in the Netherlands under the cascade,&lt;ref&gt;{{Cite web |title=Cascade |url= https://english.cbg-meb.nl/topics/bd-cascade |access-date=15 October 2023 |website=cbg-meb.nl |date= 6 October 2018 |publisher=Medicines Evaluation Board}}&lt;/ref&gt; since its approval for the use in human COVID-19 treatment.|name=NLnote|group=lower-alpha}} and the United Kingdom (since August 2021).&lt;ref name=&quot;:0&quot; /&gt; In naturally infected cats, a recovery rate of over 80% has been observed with GS-441524 treatment in several studies and in treatment programs in countries where the drug is legalised.&lt;ref name=&quot;:0&quot; /&gt;&lt;ref&gt;{{Cite web |title=Successful Feline Infectious Peritonitis Treatment with Remdesivir at the RVC |url=https://www.rvc.ac.uk/clinical-connections/successful-feline-infectious-peritonitis-treatment-with-remdesivir |access-date=15 October 2023 |website=RVC.ac.uk}}&lt;/ref&gt;&lt;ref&gt;{{Cite web |title=FIP Antivirals – Fight FIP |url=https://blogs.cornell.edu/fightfip/fip-antivirals/ |access-date=15 October 2023 |website=blogs.cornell.edu |publisher=Whittaker Lab - [[Cornell University]]}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal |last1=Jones |first1=Sarah |last2=Novicoff |first2=Wendy |last3=Nadeau |first3=Julie |last4=Evans |first4=Samantha |date=30 July 2021 |title=Unlicensed GS-441524-Like Antiviral Therapy Can Be Effective for at-Home Treatment of Feline Infectious Peritonitis |journal=Animals |volume=11 |issue=8 |pages=2257 |doi=10.3390/ani11082257 |issn=2076-2615 |pmc=8388366 |pmid=34438720 |doi-access=free }}&lt;/ref&gt;

====GC376====
{{See also|GC376|}}

An experimental antiviral drug called [[GC376]] was used in a field trial of 20 cats: seven cats went into remission, and 13 cats responded initially but relapsed and were euthanized. This drug is not yet (as of 2017) commercially available.&lt;ref&gt;{{cite journal |last1=Pedersen |first1=N. C. |last2=Kim |first2=Y. |last3=Liu |first3=H. |last4=Galasiti Kankanamalage |first4=A. C. |last5=Eckstrand |first5=C. |last6=Groutas |first6=W. C. |last7=Bannasch|first7=M. |last8=Meadows |first8=J. M. |last9=Chang |first9=K. O. |s2cid=4595813 |date=13 September 2017 |title=Efficacy of a 3C-like protease inhibitor in treating various forms of acquired feline infectious peritonitis |journal=Journal of Feline Medicine and Surgery |volume=20 |issue=4 |pages=378–392 |doi=10.1177/1098612X17729626 |pmid=28901812 |pmc=5871025 |doi-access=free}}&lt;/ref&gt;

====Molnupiravir====
{{See also|Molnupiravir}}

Facing a high-fatality FCoV-23 outbreak on the island nation of [[Cyprus]], on 8 August 2023 the government released 80,000 anti-COVID [[molnupiravir]] pills from its national [[COVID-19]] stockpile, in a bid to solve the feline coronavirus crisis in a more cost-effective manner.&lt;ref name=&quot;Feline coronavirus&quot;&gt;{{cite news |last1=Smith |first1=Helena |title=Cyprus to begin treating island's sick cats with anti-Covid pills |url=https://www.theguardian.com/world/2023/aug/10/cyprus-begins-treating-islands-sick-cats-with-anti-covid-pills |access-date=15 August 2023 |work=The Guardian |date=10 August 2023 |archive-url=https://web.archive.org/web/20230813001224/https://www.theguardian.com/world/2023/aug/10/cyprus-begins-treating-islands-sick-cats-with-anti-covid-pills |archive-date=13 August 2023}}&lt;/ref&gt;

=== Immunostimulants ===
[[Immunostimulant]]s are drugs that make the immune system more active against the virus. The most common drugs of this class for treating FIP are either [[recombinant feline interferon omega]] (Virbagen Omega, Virbac) or human
[[interferon alfa-2b]]. Since the human version ends up being targeted by the immune system for being a foreign [[antigen]], the feline version feline interferon is more effective.&lt;ref name=&quot;WW&quot;&gt;{{cite web |last1=Forney |first1=Barbara |title=Interferon Alpha-2B for Veterinary Use |url=https://www.wedgewoodpharmacy.com/learning-center/professional-monographs/interferon-alpha-2b-for-veterinary-use.html |website=Wedgewood Pharmacy}}&lt;/ref&gt;

An experimental [[Polyprenol|polyprenyl]] [[immunostimulant]] (PI) is manufactured by Sass and Sass and tested by Dr. Al Legendre, who described survival over 1 year in three cats diagnosed with FIP and treated with the medicine.&lt;ref&gt;{{cite journal |last1=Legendre |first1=A. M. |last2=Bartges |first2=J. W. |date=1 August 2009 |title=Effect of Polyprenyl Immunostimulant on the survival times of three cats with the dry form of feline infectious peritonitis |journal=Journal of Feline Medicine and Surgery |volume=11 |issue=8 |pages=624–626 |doi=10.1016/j.jfms.2008.12.002 |pmc=7130077 |pmid=19482534}}&lt;/ref&gt; In a subsequent field study of 60 cats with non-effusive FIP treated with PI, 52 cats (87%) died before 200 days, but eight cats survived over 200 days from the start of PI treatment for and four of those survived beyond 300 days.&lt;ref&gt;{{cite journal |last1=Legendre |first1=A. M. |last2=Kuritz |first2=T. |last3=Galyon |first3=G. |last4=Baylor |first4=V. M. |last5=Heidel |first5=R. E. |date=14 February 2017 |title=Polyprenyl Immunostimulant Treatment of Cats with Presumptive Non-Effusive Feline Infectious Peritonitis In a Field Study |journal=Frontiers in Veterinary Science |volume=4 |pages=7 |doi=10.3389/fvets.2017.00007 |pmc=5306384 |pmid=28261584 |s2cid=4835088 |doi-access=free}}&lt;/ref&gt;

===Anti-inflammatory drugs===
It is recommended to use an [[anti-inflammatory drug]] against FIP.&lt;ref name=&quot;antiinflam&quot; /&gt;

[[Immunosuppressive drug]]s dampen the immune system, helping to reduce [[inflammation]]. The go-to immunosuppressive drug in FIP is [[prednisolone]], a [[corticosteroid]]. There are no placebo-controlled trials showing prednisolone to be better than other anti-inflammatories.&lt;ref name='antiinflam'&gt;{{cite journal |last1=Hugo |first1=T. B. |last2=Heading |first2=K. L. |title=Prolonged survival of a cat diagnosed with feline infectious peritonitis by immunohistochemistry |journal=The Canadian Veterinary Journal |date=January 2015 |volume=56 |issue=1 |pages=53–8 |pmid=25565715 |pmc=4266056}}&lt;/ref&gt;

== Prevention ==

=== Vaccination ===
There is no effective vaccine against FIPV. [[DNA vaccination]] with [[plasmids]] encoding FIPV proteins failed to produce immunity.&lt;ref&gt;{{cite journal |title=Adverse effects of feline IL-12 during DNA vaccination against feline infectious peritonitis virus |journal=[[Journal of General Virology]] |date=2002 |pmid=11752695 |last1=Glansbeek |first1=H. L. |last2=Haagmans |first2=B. L. |last3=Te Lintelo |first3=E. G. |last4=Egberink |first4=H. F. |last5=Duquesne |first5=V. |last6=Aubert |first6=A. |last7=Horzinek |first7=M. C. |last8=Rottier |first8=P. J. M. |volume=83|issue=Pt 1|pages=1–10|doi=10.1099/0022-1317-83-1-1|doi-access=free}}&lt;/ref&gt; Rather, it was observed that antibodies to the FIPV [[coronavirus spike protein|spike protein]] exacerbate the disease.
==In film==
A 2018 film titled ''Aeris'', by Paul Castro Jr. and Aly Miller, and starring Frank Deal, Arabella Oz and [[Betsy Aidem]], is about a kitten born with FIP that is purchased from a pet store and the owners' twelve days with it.&lt;ref&gt;{{cite web |website=[[Rotten Tomatoes]] |url=https://www.rottentomatoes.com/m/aeris |title=Aeris (2018)}}&lt;/ref&gt;&lt;ref&gt;{{cite web |publisher=[[The Purrington Post]] |date=30 November 2016 |url=https://www.thepurringtonpost.com/aeris-the-movie/ |title=The Story of Aeris: A Legacy Inspired by Love}}&lt;/ref&gt; The film received an award at the 2018 [[Garden State Film Festival]] in the Narrative Short category&lt;ref&gt;{{cite web |publisher=New Jersey Stage |date=10 April 2018 |url=https://www.newjerseystage.com/articles/2018/04/10/garden-state-film-festival-2018-winners/ |title=Garden State Film Festival 2018 Winners}}&lt;/ref&gt; and was a Gold Kahuna winner at the 2018 Honolulu Film Awards.&lt;ref&gt;{{cite web |publisher=Honolulu Film Awards |url=http://honolulufilmawards.com/2018-winners |title=2018 Winners, 2018 Gold Kahuna Winners}}&lt;/ref&gt;

==See also==
* [[Feline leukemia virus]]
* [[Feline vaccination]]

== Explanatory notes ==
{{Notelist}}

==References==

{{Reflist}}

==External links==
* [https://www2.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/feline-infectious-peritonitis FIP Informational Brochure] from the [https://www2.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center Cornell Feline Health Center]
* [http://www.vetmed.ucdavis.edu/ccah UC Davis Center for Companion Animal Health]
* [http://vetbook.org/wiki/cat/index.php?title=Feline_infectious_peritonitis FIP (Felipedia.org)]

{{Domestic cat}}

{{DEFAULTSORT:Feline Infectious Peritonitis}}
[[Category:Cat diseases]]
[[Category:Animal viral diseases]]
[[Category:Coronavirus-associated diseases]]