What should I keep an eye on when receiving treatment for FIP?

It is most crucial to evaluate the clinical response; if it does not improve, a higher dosage may be required. When a cat is doing well, in particular, it is best to have regular blood tests tests but do note it could possibly be stressful and costly clinic visits. FIP Treatment Monitoring: should be sufficient to gauge response in those cases. It is advisable to urge cat owners to weigh their pets at home using affordable baby scales and to record their hunger, behavior, respiration rate, and other relevant factors in a journal.

The following advice is subject to modification based on the cat’s reaction to treatment:

• It is anticipated that the normothermia and demeanor would improve within 48 hours. At this point, you should get a verbal update on the cat’s development and how easy it is to medicate it.

• Following two weeks, it is important to assess weight, demeanor, and effusions (in-house scanning, belly girth measurement). Serum biochemistry and haematology can also be evaluated, with adjustments made for financial constraints as necessary (e.g., think about whether total protein, PCV, and plasma color assessment measured with a spun microhaematocrit tube could be used as an efficient and quick initial screen to determine whether further testing is necessary). Serum AGP normalization (if raised before to treatment) may be helpful in predicting remission; • The cat should be reassessed and the aforementioned tests should be conducted again after six weeks.

• The cat should have examinations after 12 weeks and, ideally, all evaluations should be normal before therapy is discontinued. Sometimes noted, although unrelated to recurrence, are moderate chronic hyperglobulinemia and mild abdominal lymphadenomegaly. It is still possible to quit medication if every other parameter—including AGP—is normal.

In the event that it is accessible and reasonably priced, point-of-care ultrasound (POCUS) for assessing lymph node size and/or effusion resolution is helpful.

What can I anticipate from my FIP treatment?

• You should notice a change in mood, appetite, resolution of pyrexia, and, if any, a decrease in abdomen or pleural fluid during the first two to five days.

• During the first few days of therapy, that is, before the medicine has had a chance to take action, there may be more clinical indications that are due to FIP. For example, if the cat is at home, urge the owner to assess the cat’s resting respiratory rate and effort. This can also involve the formation or return of pleural effusion, which may require drainage. There might also be neurological or uveitis symptoms (owners noticing a change in iris color, for example). Changes in neurological or ocular function should prompt an evaluation of the medication dose to determine whether an increase is necessary.

• Usually, effusions go away in two weeks. If an effusion persists after two weeks, think about raising the dosage (ideally by 2-3 mg/mg twice day, or every 12 hours), for example, to a level higher than that recommended for cats with effusions alone.

• It may take several weeks for serum albumin to rise and globulins to fall (i.e., to normalize); however, keep in mind that globulins may initially rise when a significant volume of effusion is absorbed. When all other parameters have returned to normal, there is a chance that globulins will still be slightly elevated at the conclusion of the treatment cycle. This has not been linked to recurrence.

• Anaemia and lymphopenia may take up to 10 weeks to resolve, and effective therapy may result in lymphocytosis and eosinophilia.

• Enlarged lymph nodes usually shrink over a few weeks, but occasionally, even after the conclusion of treatment, they may not regain their normal size or ultrasonographic echogenicity. If all other indicators have returned to normal, however, this does not appear to indicate a relapse of FIP; therapy should be terminated as planned and the patient can be closely observed.

Should you notice less than anticipated progress, you may want to reconsider the diagnosis and/or raise the dosage.

After FIP treatment, what should I keep an eye on?

Following therapy, which typically lasts 12 weeks, owners of cats should keep an eye out for any clinical indicators of recurrence, such as appetite reduction, weight fluctuations, or other symptoms. Relapse clinical indicators might be different from original diagnostic signs (neurodiffusive signals in cats with prior effusions, for example). Examining the cat around four weeks after quitting therapy is ideal. If AGP stays normal, monitoring it could give comfort. It is important to look into any clinical symptoms very away.

Can I utilize any complementary therapies while treating FIP?

Different forms of supportive care may be beneficial for cats with FIP. Antivirals have not been examined with any particular supplements, and using numerous oral drugs may not be the best option because of patient compliance issues and associated expenses. Cats who are ill and dehydrated, however, can need intravenous hydration treatment. Depending on the situation, one may consider the following interventions:

• Neural lesions, uveitis, peritoneal and pleural inflammation, and distension from masses can all cause discomfort in affected cats. As part of multimodal analgesia, therapy with opioids, such as buprenorphine, and other medications, such as NSAIDs, may be beneficial if the cat is eating and its renal parameters and hydration status are normal;

• Repeat drainage of pleural effusions may be necessary throughout the first treatment period;

• Normal drainage of abdominal effusions occurs only when pressure is compromising breathing;

• Nutrition is crucial since cats with FIP frequently lose weight and change in physical appearance. Due to nasal tubes’ poor tolerance and potential for depression, cats with profound anorexia who are not responsive to the aforementioned medications may benefit from the placement of an oesophagostomy (O-)tube.

• Additionally, some sick cats may benefit from the short-term placement of feeding tubes, which can facilitate medicating. Medication like maropitant can help cats feel better when they’re queasy and stimulate them to eat;

• Blood transfusion may be necessary in addition to antivirals in certain cases of severe (and occasionally hemolytic) anemia caused by FIP; hepatoprotectants, such as S-adenosyl methionine (SAME), with or without silybin, are generally not necessary, even in cats whose ALT enzyme activity is elevated;

• and corticosteroids are generally contraindicated in the treatment of FIP with antivirals in order to prevent side effects and immunosuppression. On the other hand, cats with severe neurological symptoms may occasionally need short-term systemic corticosteroids (1–5 days) to decrease inflammation. Cats with uveitis may also benefit from topical corticosteroids. Immunomediated hemolytic anemia (IMHA) is a rare side effect of feline immune plexopathy (FIP) that frequently requires systemic corticosteroid therapy for an extended period of time in addition to antiviral therapy to help alleviate the anemia. Consider administering an NSAID to cats receiving FIP therapy if an anti-inflammatory medication is necessary (provided that the cat is eating and its renal and hydration parameters are normal).