Dr. Pederson's second reply...
Michelle
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Dear Ms. Lerner: Yes, there are some strains of FeLV that are not as
pathogenic, and cats will live a lot longer. However, there are strains
that are much more pathogenic. Therefore, the figures I gave you are an
average, but the figures are relatively correct and helpful when counseling
owners. As for the fluid, it is compatible with FIP. The large mononuclear
cells are the same as macrophages. The cell findings support the biopsy
findings, which support the diagnosis of FIP. -Dr. Pedersen
At 10:11 AM 1/29/2007, you wrote:
Thank you so much for your reply. I am aware of the stats on felv. But my
two remaining FeLV+ cats were positive when I adopted them as adults over
4.5 years ago, and both are at least 5.5 years old already. I lost another
one who was almost 7 years old and had FeLV since she was 1 year old or
younger, and another at 5 years old, and I have a friend who had a cat who
was positive since being a kitten die recently at age 10, and another at
age 9. I have lost most of my positives to lymphoma, and one to dry FIP.
So I know that FeLV shortens their lifespans and makes them more prone to
FIP, but I also know that with appropriate care many can live well past
what the statistics say. I just don't want to write her off if there is a
chance this is not FIP and is something treatable.
You asked about the kinds of cells. Here is what the cytology report says:
"Cellularity is moderate consisting of a mixture of large mononuclear
cells, lymphocytes and neutrophils." They call it a modified transudite.
Are large mononuclear cells the same as macrophages? If so, or if not,
does this tend more toward or away form an fip diagnosis?
Thank you so much for taking the time to correspond with me about this,
Michelle Lerner
In a message dated 1/29/2007 12:25:45 P.M. Eastern Standard Time,
[EMAIL PROTECTED] writes:
Dear Ms. Lerner: I can only give you opinions, because I have not seen the
cat and I am not your veterinarian. However, I can make a few comments
that may or may not be helpful. First, there are things that support
effusive FIP. The cat is FeLV+, and we know that FeLV infection is the
greatest potentiator of FIP in existance. If a cat has a subclinical
(latent) FIP infection, which some cats can have for months, years, or
even a lifetime, FeLV infection will almost always activate it. In the old
days before FeLV was controlled, about 40% of the cats with FIP were FeLV
infected. Second, the fever and the presence of granulomatous inflammation
in mesenteric lymph nodes are signs of FIP. The fluid is not typical of
the usual case of FIP, but in a small percentage of cases the fluid can be
lower in protein and not yellow. You did not mention the cell count - the
cell count in the fluid is usually several thousands, but also can be low.
the important thing is what cells are in the fluid. FIP fluid contains
neutrophils, lymphocytes and macrophages. The differential for this type
of fluid would be either some form of heart failure, such as
cardiomyopathy, or some obstruction in the veins going into the liver. The
latter fluid, however, would be bloody. The cardiomyopathy can be ruled
out by an ultrasound exam of the hart, preferably done by a veterinary
cardiologist with proper equipment.
As for the treatment you are on - none of the drugs have anything
to do with treating FIP (although, I am aware of the literature). The
pred or dexamethosone will take down the fever; the leukeran may decrease
the inflammation, and the interferon will do nothing but shrink your
wallet!. We know all of this from direct experience. The problem with
the Japanese studies on the interferon is that they also have a vested
interest in selling it, and they have done a good job of selling it to
vets worldwide. The clindamycin will not touch FIP virus, and it is a
million to one chance that the cat has toxoplasmosis.
In all cases like this, you have to play the odds. The odds are
that your cat has FIP and diagnostics should be directed at ruling it in
or out. You can actually do a direct PCR test on the cells spun out of
the abdominal fluid. There are good laboratories, such as IDEXX (not
Antech) that can do this. You can also seek advice from the vet school at
Cornell - they have a good diagnostic lab. You can also send it to the
Lucy Whitaker lab here at Davis. If you want to pursue the heart, you
should be able to find a veterinary cardiologist in the area. Finally,
remember that FeLV infection is a fatal disease. Almost all FeLV infected
cats will die of an FeLV-realted disease within 3 years. FIP is one of
those FeLV-related diseases. Most are dead within 2-6 months
of becoming clinically ill. Therefore, you cannot forget FeLV in the
face of all of these clinical comings and goings. good luck, Dr. Pedersen
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