Is it FIP?

[honeybeesweet]

My 2 year old cat Jasper is a very puzzling case. Over 3 months ago I noticed his stomach was getting bigger after a while I took him to the vet. Vet determined that it is fluid in the abdomen, but doesn't know why. He is not showing ANY signs of sickness or distress.
His bloodwork came back normal. He's tested negative for FELV and FIV. They took a sample of fluid and it is mostly clear (usually yellow with FIP) the test on it came back that there is protein in it.
They think maybe it is FIP, toxoplasmosis, or cancer. But none of these seem very likely to me. He has not been tested yet for FIP because the test is not conclusive. I am also considering getting utrasound of the abdomen.
I will be devastated if it's FIP, but it's strange that he's not sick. Please help me decide what to do next (tests are getting expensive).

[mamabear]

What does not seem likely to you? The fact that he might have FIP? Please don't take this the wrong but you are not a vet. There is a tech that will come on here and explain it further with details. Some cats can have no symptoms except a big belly. I would have to say that things should be done asap in order to rule out cancer or anything else. The faster the better.
Traci will be able to better help you. I will offer a prayer for him and you though. (((((honeybee and Jasper))))))

[honeybeesweet]

Thanks for your reply. My understanding was that cats with FIP usually are sick and he is acting totally normal even though his belly has been enlarged for 3 plus months. I thought this disease worked faster than that. Also, though possible, he is young for cancer.
I just got the results of the fluid analysis yesterday and will take him in tomorrow for more blood work. If that comes back negative I guess the next step is to schedule an ultrasound.
I guess I was just hoping someone might come up with another reason to explain the fluid in his abdomen. Also I wanted advice on how to deal with the non-conclusive results you get with an FIP test (once he has it done).

p.s. He is an indoor/outdoor cat and will be miserable if I have to keep him in the rest of his days. This is so hard to think about when he is acting healthy .

[Traci]

Despite what you feel, your kitty MUST be kept indoors only, from now on. You now obviously know the extreme dangers of outdoor access, feline infectious diseases are only a few of those hazards. Plus, if he isn't vaccinated or up-to-date on his other vaccinations, you are allowing him to risk OTHER cats. Even if he were FIP-positive (unlikely at this point), you are risking him infecting other cats/those cats risking your cat.

Do you have other cats? Other pets?

Can I just ask, are you certain kitty has never been ill? What about vague symptoms or even self-limiting illness recently or in the past?

First, if your vet isn't telling you anything, or recommending common rule outs and testing to rule out other things, then see a new, more qualified, feline-only vet AT ONCE (like TOMORROW). There are several things that can cause protein in fluid accumulation, and the vet needs to differentiate against those things before making assumptions of FIP. Since the fluid was clear, no history of illness, no current symptoms other than distended abdomen and protein in the fluid, it is IMPERATIVE the vet rules out the other differentials.

Do you know what the globulin levels were? The globulin, if elevated, and combined with high serum protein, would be a starting point to rule out FIP. Otherwise, I would strongly suggest a full immunological profile, to rule out fungal disease, parasitic disease (blood-borne), other viral or immune-mediated disease).....by getting one comprehensive immunological profile done, you would ultimately be saving money on other diagnostics. This profile should include whatever is necessary to rule out the following: cryptococcosis, toxoplasmosis, histo, blasto, hemobartonella, tick-borne disease, other viral infections, parasitic infections.

Additionally, heart disease, chylothorax, bacterial peritonitis, glomerulonephritis, lymphoma, or any trauma/torsion to a major organ should also be ruled out when there is fluid accumulation with a high level or protein content.

You might also want to retest the fluid (cytology) to detect any changes in a couple weeks or so.

The possibilities are too numerous to mention here, please see a new, more experienced vet TOMORROW, get current copies of kitty's health records, including current test results, faxed to the new vet immediately for review and so that the new vet can recommend which diagnostics are most useful to diagnose specifically.

I don't think a PCR for FIP is necessary at this point, but then I don't have your vet's notes, suspicions, test results to go on either, so let the new vet make that determination.....a very high titer combined with high globulin and protein levels, combined with clinical symptoms would give reason to investigate for FIP, but it doesn't sound like other factors are involved at this point, so let the new vet decide that.

Don't wait on this, and do NOT let your current vet make assumptions before you see a new, more experienced vet for a second opinion and new opinion on other diagnostics!! Too often, cats have been misdiagnosed for FIP!!

[honeybeesweet]

Thank you so much for your reply! He has really been acting like himself all this time. He eats and drinks normally, chases things, runs and jumps, and is very affectionate. He is up to date on all his vaccinations and he is the only pet in my home.
So you think FIP is unlikey? He has been exposed to lots of ticks this summer and hunts little animals, so I feel something having to do with that is more likely.
My vet was not assuming FIP. Just said that it is a possibility and can't seem to figure out what else it might be, so wanted to test for that next. I don't know what the globulin levels were, but the total protein in the fluid was 5.4, I'm not sure what that means.
So you think more complete blood work should be done before FIP test or ultrasound? How can I find a feline specailist?
Thank you so much! This has been very helpful.

[mamabear]

Hunting small animals is another reason to keep kitty inside only. You have no clue what the other animals have (ick) and therefore you are keeping kitty inside to keep him safe. He will eventually get use to it. It is us(the humans) that think they will not.

Finding a new feline only vet can be done by calling another local vet and asking the receptionist if they know of one themselves. You can go online under the white/yellow pages and search under feline Veterinarian or look in your phone book under veterinarian and see what they have their. It might say feline/cat only...

[honeybeesweet]

Thanks Mamabear. I couldn't find anything in the white/yellow pages for feline only. I just put a call into the Tufts veterinary school/hospital, maybe they can help me.

[Traci]

Depending on where you're located, call the nearest and most popular emergency vet facility for a referral. Ultimately, your current vet should have referred you to a specialist....you can call him and ask for a referral but if he doesn't know of anyone, then call an emergency vet and ask if they have referrals to a feline-only vet or specialist. You can briefly describe the situation, and the emergency vet facility may even offer you that second opinion with a new exam for your kitty, etc. You really should have all kitty's records, past and current, faxed to whomever you want to re-evaluate kitty, diagnostics, etc.

I can't say whether or not you should test specifically for FIP at this point, I do feel you should get a second opinion with a NEW exam, have the second opinion vet review kitty's records and allow him to help you make the decisions on the next step concerning diagnostics. The second opinion vet might pick up on something your current vet missed, or recommend testing that your current vet hasn't thought of.

If kitty has been in excellent health, no prior health problems, has a good vaccination history, and the only symptom is fluid containing protein, then this isn't enough to assume FIP. As mentioned before, the second opinion vet has to rule out all the other causes with additional testing, and only he/she can decide what testing is more prudent based on kitty's new exam, current health status, possibly rechecking the fluid analysis, etc.

One major concern is that he has hunted rodents, and has been exposed to ticks, parasites etc. There are numerous bacterial, viral and immunological diseases that can be transmitted via hunting/eating rodents, parasite exposure, tick exposure. Only specific immunology will determine exposure or infection. The immunology profiles must be sent to an outside lab, they can take up to 5-7 business days to obtain results, so it's important that if the vets suggest them, get them done IMMEDIATELY. Fungal disease or bacterial infection within the chest or abdomen, heart, lungs, lungworm, etc etc are amoung the rule-outs that should be done ASAP.

Regardless if your current vet is taking more blood for more bloodwork today, you need to understand WHAT tests he is doing, and WHY. If he seemed clueless before and never offered to refer you to a feline-only vet or any vet more experienced than he, a specialist, etc, do not waste any more time with him, get a second opinion immediately. We're talking a day here, do not wait!

[honeybeesweet]

Traci,
Thank you so much for all your advice. I am taking him to see a specialist at Tufts tomorrow AM. I do think it's strange that my vet never recommended that I go to a specialist.
I am going to print out your messages and take it with me so nothing is forgotten.