Vet360 Vol 03 Issue 03 June 2016 | Page 18

CPD ACCREDITED ARTICLE body titre than have died from FIP. Conversely, some cats with acute FIP will not have an antibody titre and some patients with terminal disease may test negative asdall antibody is all bound to viral antigen.3 The diagnosis of this disease should never ever be based on antibody titres alone. Very high titres of > 1:1600 can be used as a very small piece of the puzzle only.2 PCR in blood: Routinely offered PCR detection of coronavirus in blood is not useful, as the test cannot distinguish between FCoV and FIPV. In addition, false negatives occur commonly.3 A mutation in the spike protein (a protein on the viral envelope that assists with cell invasion) of the FCoV has recently been identified which appears to be associated with systemic spread of the virus (and therefore may be associated with FIPV). A RT-PCR which detects this mutation is commercially available in Europe, but the presence of the mutation is still not 100% specific for the presence of FIP.7 PCR of faeces should only be used to identify FCoV shedders for the purposes of controlling viral spread in catteries. Conclusion The diagnosis of FIP is not always straightforward and a combination of findings, or pieces of the puzzle, need to be considered together. Finding more pieces will give a clearer picture, and some pieces make a bigger contribution than others. FIP is NOT contagious: Cats shed FCoV, which has a possibility of mutating to FIPV in specific cats those with immunocompromise or immature immune systems, and those in high stress, multi-cat environments FIP is an SYSTEMIC disease - not an ENTERIC disease - and virus is not shed in the faeces. Serum electrophoresis: Electrophoresis patterns may show either a monoclonal or polyclonal increase in gamma globulins, and are not specific for FIP. An alpha-2 globulin increase may be present, representing the increase in acute phase proteins, but is also a non-specific change. Additionally the serum A/G ratio has a higher diagnostic value than the gamma globulin concentration.6 Electrophoresis is therefore not a useful puzzle piece for the diagnosis of FIP. Accredited CPD Acute phase proteins: Acute phase proteins like serum amyloid A, haptoglobin and alpha(1)-acid glycoprotein (AGP) are elevated in cats with FIP, but increases are also expected in any systemic inflammatory disease. AGP however has been investigated in detail and increases above 1.5-2 mg/mL can potentially discriminate cats with FIP from those without FIP but with clinical signs consistent with the disease.8 This suggests that AGP is a useful puzzle piece but this test is unfortunately not available in South Africa. ANSWER the questions on the Vet360 App. Available from the Itunes/Play store! Use your App to answer the questions. If you want to use the SMS system or the web interface on your PC, please visit the CPD electronic platform at www.onlinevets.co.za Use the following codes for the SMS system: 10. The FIP Jigsaw-Puzzle. Dr Emma Hooijberg SMS code: a71336 9. Otitis Externa. Dr Martin Briggs. SMS code = a22785 8. Canine Idiopathic Dilated Cardiomyopathy. Dr Alain Carter. SMS code = SMS code = a68068 7. Cushings. Various Authors. SMS code = a20643 6. Cyclosporine in Canine Atopy. Dr Heidi Schroeder. SMS code = a24438 5. Management of Diabetes Mellitus Dr Marlies Bohm. a55046 4. Transfusion Medicine in Small Animal Practice. Dr Liesel van der Merwe SMS code = a90559 3. Diagnosis of Demodicosis in Dogs & Cats. Karen A. Moriello SMS code = a22801 2. A review of sterilisation practices and impact on the individual animal, in dogs and cats. Drs K de Cramer and K May SMS code = a26581 1. Rehabilitation of neurological patients. Dr Megan Kelly, SMS code = a97907 vet360 Issue 03 | JUNE 2016 | 18 JUNE 2016 Vet360 working.indd 18 2016/05/24 12:04 AM