Case Of the Month

Dry Form Feline Infectious Peritonitis

Dry Form Feline Infectious Peritonitis. Another great mystery turned inside out with the ultrasound probe.
Imaging performed by Dr. Lindsey Daniel, NJ Mobile Associates & Mobile Veterinary Ultrasound, Atlanta, GA, Case managed by Dr. Jim Brousse & staff at Cat and Dog Clinic, Athens, Georgia.

History (Kohmescer): Smokey, an 11-year-old, M/N, DSH indoor/outdoor cat. His presenting complaint was weight loss and anemia, and he was negative for FELV (+ for FIV from vaccination). Bloodwork was otherwise uneventful.

Outcome

The patient was put on supportive care post surgery. Patient is doing well 2 months after surgery (Intestinal resection).

Comments

Special thanks to Dr. Jim Brousse & staff at Cat and Dog Clinic, Athens, Georgia for the thorough management of this case. Also special thanks to Dr. Lindsey Daniel, NJ Mobile Associates & Mobile Veterinary Ultrasound, Atlanta, GA for submitting this case.

Clinical Differential Diagnosis

(Remo Lobetti PhD, DECVIM): Differentials include gastrointestinal tract blood loss (neoplasia, foreign body, ulcer), anemia of chronic infection, neoplasia, bone marrow pathology, lead/zinc toxicity, systemic mastocytosis.

Sampling

FNA of both the lymph nodes and the colonic infiltrate were inconclusive, so exploratory surgery and the referring veterinarian performed biopsies.

Primary surgical differential was neoplasia such as lymphoma. However, surgically obtained histopathology was both “characteristic and diagnostic” for FIP. The pathologist described the GI lesions (colon) and the lymph node as “granulomatous, multifocal, moderate; with necrosis”. The laboratory also performed Immunostaining for Feline Coronavirus on the colon, which was positive for FECV.

Sonographic Differential Diagnosis

(Lindquist DMV, DABVP): Infiltrated descending colon with associated lymphadenopathy. Loss of intestinal mural detail and structural loss in the adjacent lymph node meets neoplastic criteria such as that of lymphoma, mast cell disease, and less likely intestinal carcinoma. Complicated inflammatory disease (IBD) bacterial, fungal, viral colitis, or dry form FIP also possible with associated lymphadenitis.

Video

Patient Information

Gender : Male, Neutered

Species : Feline