Tuesday 14 October 2014

Ilana's cat survives with wet FIP

 I don't stop in here now except to bring the good news stories - yes in amongst all the heartbreak there are SURVIVORS!!! and as always much love and caring from people like the tireless Oscar Birman who will hold your hand across the internet on the FIP facebook page where we were told about Illana's cat. They live in France where Dr Addie is now ( you can read about her protocols on treatment page ).
Ilana Dagan My cat had the wet FIP and she takes prednisolone every day and interferon (for human, less expensive).I told my vet about the web site of dr diane addie who wrote about FIP and we found there the right treatment for my cat.She had no more fever,no more fluid in the abdomen and she gained back her weight,it was 8 months ago and she is still very fine! ~ 15/10/14 https://www.facebook.com/groups/fipfighters/798509346862004
I've asked Ilana for more details and a photo and she agreed although I still haven't got these - hopefully these will be sent and we can keep tabs on how her cat fared weaning off the drugs.
Please make sure to read my notes on diagnosis, treatment and the actual survivor case histories, where you will find links to notes about Dr Addie's protocols, and do touchbase with the FIP facebook group for support no matter what the outcome.
Wishing much peace and love to you,
Carolyn

Update Jan 2015 Ilana's cat i think is still ok but I've messaged her again for more info.

Monday 23 June 2014

The Dragon's Blessing

"the dragon's blessing - this deep understanding that suffering can be transformed and be transformative" ~ Guy Allenby


FIP is all about stress. Cat stress. Human stress - my son and I lost our appetites, stopped eating. I lost my spare tire and gained more under eye bags. Naturally we both got a cold almost immediately. Now I don't believe in God, I don't pray - there were no other adults to support me deeply emotionally; even worse - the vets were out of useful ideas so I was searching the internet until the small hours of the morning. I needed to stay strong for Mishka and for Michael. Plus there was no darn way I was going to let FIP take our health as well. 

So from that spiritual void to calm everyone's panic, ease their pain, and later, to mend a broken heart I reached out for music therapy and meditation. All the wooo hippy junk I wasn't going to bother with when I was younger and life was easy. Certainly not in medical school - I was there to learn about drugs and surgical interventions.

I didn't really believe in the power of the mind until a christmas holiday a few years ago. It just bucketed down, and the family's holiday at Coolum was not the escape to sunny Queensland promised. So while Brisbane flooded and a state of emergence was declared, I retreated to the spa to sauna, sip tea and read Dr. Ian Gawler's biography "the Dragon's Blessing". Studies over the years have increasingly backed up what was at the heart of his healing from 'terminal' sarcoma but much derided at the time and for many years after - meditation. It improves the immune system, critical thinking and memory. With FIP I needed all of these things for each of us FAST without heading for a pill bottle. Music of the right frequency was a shortcut to moving our minds into the zone. There's an abundance of suitable music for free on youtube. It far exceeded my hopes for keeping Mishka comfortable and everyone calm during any therapy. Since she was a highly strung cat and we were all empathically wired in together, one buzz in the wrong direction could wind us all up. We even found one track that reliably sent her and my son to sleep quickly. I have kept adding to the playlist now and then for pleasure. It's unintentionally chronicled a mental healing with the tone of the tracks becoming brighter over time.

 Other resources

Dr. Hedy Kober, a neuroscientist at Yale talks about how she began practising meditation to mend her broken heart.

Other resources I collected along the way are on the support and solace webpage. The most amazing was the facebook community - please also check that out and find what blessings you can as you face FIP.

Wednesday 2 April 2014

Pikachu - a wobbly cat

Pikachu does not seem to have FIP although one vet he was taken to made this diagnosis. He was a wobbler (ataxia) because his brain or inner ear ( vestibular system responsible for balance) had damage after a viral illness but is getting better on PI (polyprenyl immunostimmulant) since early Nov 2012 " For the first few months, his ataxia waxed and waned, but now all that remains is a head tilt and the deafness. The head tilt seems to get worse/more exaggerated when he has a UTI or some other issue affecting his general health. He is doing really well now, although it took months to recover, and he still has a few neurological deficits. My only worry is that the virus may reactivate in his system and he won't be able to fight it off again"
"He was first diagnosed in September/October 2012. We took him to an emergency vet because he was ataxic (wobbly) and had nystagmus (shaking eyes). They originally diagnosed him with Idiopathic Vestibular Disease and said it would resolve within two weeks. When he didn't get better, we got a referral to a neurologist who did an MRI, Spinal Tap, FIP titer, toxoplasmosis test, etc., and said it was in his central nervous system and diagnosed dry FIP. After he became ill, we noticed he had lost his hearing completely. We were basically told to say goodbye to him, but you can't give up as long as you have hope. 
The neuro was ready to give up on Pika and really had no interest in PI or Dr. Legendre. I found the information on Dr. Legendre's success with PI and PUSHED the neuro to contact him and write the rx for the PI. Even after he contacted the university, he called me back and told me it was too costly and I should just put Pika down. It was unbelievably frustrating! I'm soo glad I didn't follow his advice. Even if the PI didn't help his situation, it certainly must have boosted his immune system in general and definitely didn't hurt him. " Kathleen Maki Potts
 She sent his results to the FIP fighters for opinions.
 "Pika's A/G ratio is 0.9. Anything above 0.8 almost always rules out FIP. A positive titer for FIP only means exposure to FCoV. It is not predictive of FIP. An extremely high titer, along with other suspicious lab results would make me think different. Also the 7b ELISA was negative. I would definitely explore some of the CNS stuff and it looks like your vet is doing a good job and looking at other things. You can always print out Dr. Addie's flowchart and provide to your vet if they start to explore the possible diagnosis of FIP again. The slightly elevated liver values can just be dehydration or a low grade infection."
Moki is a 'famous' facebook cat who seems to have a similar mystery wobbly problem but which didn't resolve, also initially diagnosed as FIP.

Tigger

"I'm so happy I could bounce!" ~ Tigger


This is a story I got from one of the FIP yahoo groups. It has stayed in the drafts folder of this blog for over a year. I didn't manage to contact Tigger's mum for more details, a picture and so on. Post is copied verbatim as I expect Tigger's mum wants the story out there. So sadly I don't have details of diagnosis, no bloodwork - that's a caveat, it may not be FIP but it's hard to think of what else could have made him so sick for 6 weeks; my notes say wet FIP.  I can see the precipitating immune suppressing causes are pretty common ones. The move was big one as I recall; I think Tigger had to take a plane ride and was received at the other end unwell. He is a little older than usual. Most importantly Tigger's successful treatment has commonalities with other survivors - antibiotics combined with IV fluids and an immune stimulant - in this case interferon ( i think probably it is feline interferon since this cat is in Europe. ) special food (again wish I knew the details!) and intense daily attention.
Hi. I have a rambunctious male 5 year old cat. His name is Tigger. 5 months ago, I moved to Turkey. He had a shot for Luekemia (sp prob wrong) Anyway BAD idea. Don't ever get your cat a shot for this without getting him tested for the corona virus. I'm not sure if I spelled that right either but it's easy enough for you to google.
Anyway, the move and shot sent him into full blown FIP. His eyes were rolling to the back of his head, sky high fever, skin and bones, boy did I thought he was a goner. We started interferon and vitamins, antibiotics and Iv every day for a month and a half. Each day I spent 2-3 hours at the vet. 5 months later, he is alive and fat and happy. Each day I give him 2 vitamins. One in the morning and one at night. And they have garlic in them, yes, garlic.
If you make a serious commitment to keep your cat alive, I believe you have a pretty good shot of beating this with the help of interferon. I also give him food for sensitive systems and NO treats!! TReats do not help any cat. I have a second cat that seems to be fine and probably live to be 20. Tigger is living on borrowed time but I treasure ever extra moment. I also keep their cat box VERY clean. 2ce a day I clean it. My heart goes out to all owners with fip cats. It's heart wrenching, I know.
My other thought, a year of case history reviews later, is that I feel vets are not paying enough attention to fluid and salt (electrolyte) managment in FIP cats. Sick inapetant cats are easily dehydrated as they are desert animals designed to get most of their fluids from freshly killed prey. Vets seem to devote all the owner's resources to diagnostic gymnastics while their patient slips away from under their noses. Any reasonably sick human wheeled into an ER would be instantly hooked to an IV while this is worked out.
Also on the home front I doubt this cat was left to waste his remaining energy dragging himself to a litterbox too far, up a flight of stairs to the bedroom or being needlessly stressed by a bath (this is not sarcasm - I do actually know of someone who went to the trouble of getting PI then bathed their FIP cat. Predictably it took a downhill turn from there and is not listed on my survivors log.)

picture by felicia ruiyi - deviantart



Wednesday 26 March 2014

Murphy - misdiagnosis of wet FIP

Mischievous Murphy from Germany is a kitten successfully treated for bacterial peritonitis which was initially mis-diagnosed as FIP in April 2013 when he was 8 months old. Fortunately Jennifer did not give up. She found a second opinion from another vet, who although she could not rule out FIP even though his abdominal fluid tested negative for coronavirus, committed to save him and went for treating the treatable in the face of uncertainty. Murphy was given Suanatem (Metronidazole and Spiramycin) and recovered quickly.

This continues the series on misdiagnosis. Please make sure you check out Dr Addies's diagnostic algorithm's for FIP on treatment page before losing hope. And donate to FIP research which is working towards a fast and reliable diagnostic tool. In australia this is University of Sydney with Jaqui Norris.

Thursday 13 March 2014

Mutant Ninja FIP

"Evolutionary plasticity can be purchased only at the ruthlessly dear price of continuously sacrificing some individuals to death from unfavourable mutations."

~Theodosius Dobzhansky Genetics and the Origin of Species (1937)

Life does not stand still. Evidence of the mutation of Feline crossed Canine coronavirus to produce a virulent form that creates directly cat-cat transmissible FIP disease. Marleen from Facebook FIP fighters group posted this today -
"One of our members contacted Dr. Niels Pedersen from the UC Davic SOCK FIP team and he kindly sent her this lengthy reply (see below). She got his permision to share this with the FIP community.
Q: In a recent article by Wang et al (http://www.veterinaryresearch.org/content/44/1/57) an outbreak of FIP among cats in a Taiwanese shelter was described. This has caused some anxiety among cat owners concerning the potential of cat-to-cat transmission of FIPV. What are your views on this? 
A: I reviewed this paper and believe that this was a case that started with cat-to-cat transmission. However, the virus in this outbreak is what we call type II FIPV, which is a hybrid that occurs between feline and canine coronavirus. The primary strain of coronavirus in most cats is serotype I. Serotype II FIPV are more virulent than type I viruses and there is an old report of possible cat-to-cat transmission with another FIP virus of this serotype. However, this is a very rare occurrence and should not be taken as a universal finding. Cat-to-cat transmission of FIPV is extremely uncommon, even with serotype II virus, and when it occurs the outbreaks are self-limiting because the virus rapidly mutates to a form that does not go cat-to-cat. It is likely that the virus in this outbreak came from a cat or cats that were housed with dogs in another shelter and had not yet had time to fully adapt to cats. 
At this point, we need to define the difference between epizootic (epidemic=human) and enzootic (endemic=human) disease. An epizootic occurs when a new pathogen such as a virus enters a group of susceptible animals for the first time. There is a very rapid spread with a high morbidity (prevalence of diseased individuals) and often a high mortality (death from that disesae). An example would be the appearance of parvo virus enteritis in dogs in the 1970s, an epizootic disease that is now enzootic. Enzootic disease occurs when a pathogen lurks continuously in the environment and only targets individuals that become susceptible. For instance, feline enteric coronavirus is shed by a majority of older cats in a cattery but it is the kittens that take the brunt of disease. Enzootic disease is sporadic in nature and the morbidity and mortality waxes and wanes depending on the presence or absence of disease cofactors. People often mistake epizootic for enzootic disease when several cases occur close together. Epizootics usually get far more attention than enzootics, because they hit like a hammer. Enzootic disease is frequently tolerated, as is the case with feline upper respiratory and intestinal infections and even with FIP. However, the tap-tap-tap of enzootic disease is in the long run far more damaging and causes far more deaths than epizootic disease. 

Q: How can an epizootic of FIP, such as occurred in this Taiwan shelter, be differentiated from the enzootic type disease that causes almost all FIP deaths? Or another way to ask the question in the case of FIP is how can you differentiate cat-to-cat transmission of an FIP virus from the normal pattern of infection, which involves cat-to-cat transmission of the parent feline enteric coronavirus followed by internal mutation of the disease causing FIP virus?
A:  The epizootic of FIP that occurred in Taiwan was easy to characterize, because it could be traced to the introduction of a specific hybrid cat/dog virus that came in with a cat from another environment. This virus then rapidly spread to susceptible cats by contact. The virus that caused the epizootic was also genetically unique from normal enteric coronaviruses that were enzootic to the shelter, confirming that it was indeed a new introduction. As would be expected from an epizootic, the introduced virus changed as it rapidly spread cat-to-cat in the shelter. With subsequent cat passages, the infecting virus started developing mutations in one of the coronavirus-related genes associated with production of a protein called 3c. Coronaviruses that do not produce normal 3c protein will no longer infect enterocytes and are therefore not shed in the feces. This same type of mutation is common to the FIP viruses isolated from cats with enzootic disease. This occurrence of 3c gene mutations was probably the major reason why the Taiwanese outbreak was self-limiting, and not just because a simple quarantine was initiated.

Q: We can all understand that cases of FIP commonly occur in large catteries where FECV is prevalent, and where there is a genetic relationship between affected cats. However, there are also cases where 3-4 genetically unrelated cats in the same household (not a large cattery) develop FIP one after the other during a time period of 6-12 months. Assuming that all of these cats developed FIP due to internal mutation of FECV, this seems a bit strange considering that only a small proportion of cats are supposed to go on and develop FIP after FECV infection. How do you explain this?
A: The morbidity to FIP can range from less than 1% to more than 5-20% in the enzootic form, depending on many factors. In catteries, genetics play an important role, but it is not the sole factor. With random bred cats, non-genetic factors are even more important. We know that the age at exposure to FECV and stressors of many types that occur during primary FECV infection (starting around 9 weeks) are very important. Resistance develops with age and the younger they are exposed the more likely to come down. The problem is that in shelters and catteries the exposure occurs much earlier in life than if cats are running free at a reasonable density. There is no accident that over 70% of FIP cases come from catteries, shelters and kitten/cat foster and rescue organizations. We also know that 20% or more of FECV infections can generate FIP-causing mutants, but yet only a fraction of cats get sick. This means that many cats actually resist the disease. The question then becomes - why do some get the disease when others do not?

Q: Which are the most important stress factors that can influence the development of FIP in young cats?
A: In principle anything that interferes with a kitten’s immune response in that critical period between 9 weeks when they usually first see FECV and 16 weeks or so when their immune system really starts to become mature can potentially tip the balance towards disease. Vaccinations, deworming, early neutering, moving to a new family – all of these things can affect the immune system, plus all of the common kittenhood respiratory and enteric disorders that occur during this period. However, it is impossible to weight the influence of one or another, or any combination. I like to use the term “perfect storm” from the famous movie. You get FIP when enough bad things come together at the wrong time.

The Bottom Line - House your cats in small groups. Do not stress them when they are young. Protect kittens from encountering FeCoV until their immune system is strong and don't inbreed.

Saturday 1 March 2014

Preventing FIP is simple

"God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."Reinhold Niebuhr

What really really makes me mad about FIP is the complacency in the cat owning community since it is supposedly a coronavirus mutation confined to the unlucky individual cat and furthermore not transmissable to humans; FeCoV (feline coronavirus) is an oral fecal thing and has a very short persistance outside a host therefor theoretically easy to beat. No FeCOV = no FIP. Worse things have been banished with no more exciting weapons than soap, clean water and flushing loos.
"FIP is pretty rare in housecats who are not exposed to other cats, occurring in roughly 1 in 5000 cats in this situation. FIP is fairly common in catteries in which feline coronavirus carriers are present, occurring in about 1 in 20 cats in this situation." 
Read more: Feline Infectious Peritonitis( FIP) and Feline coronavirus (FeCoV) - VetInfo 
What really really scares me about FIP though is the breeding of virulence by letting it cycle multiple times through kitty hosts who are unaturally confined indoors with an abnormal number of other potential hosts, who are to boot, probably immune suppressed through poor diet and inbreeding. "Wu Lien-teh, moreover, suggested that virulence increases in the course of an epidemic. Dongzheng Yu conducted a series of experiments in rats to test this idea. He injected them with a strain of plague from wild rodents; the injected rats were not easily infected and died slowly. Next, he withdrew plague bacteria from those rats and injected it into others, and on and on. Eventually, this serial passage produced a plague strain so lethal that rats injected with only a tiny amount died rapidly, suggesting that the strain's virulence had markedly increased." http://discovermagazine.com/2001/nov/featblack#.UaXtboLC--k

The knee jerk reaction, massive culling, as happened to the civet cats in China during SARS, is probably counterproductive - civets have low immunity anyway, why ruin the genepool further?
 "The last thing we should do is to take it out on the bats, because the evidence suggests that they have carried this coronavirus for thousands, perhaps millions, of years; only recently has it emerged in a big way, and it was human behaviours that made the difference." http://evolution.berkeley.edu/evolibrary/news/060101_batsars
We need to change our behaviours now, because this is the one thing about FIP we can control while still dreaming of some miracle pill - and it's entirely DOABLE http://www.dr-addie.com/Prevention/PreventionS1.htm#How to eliminate FCoV infection from a cattery

Tomten - thoughts on inflammation

"drink the wine drink the wine- music, good friends, I'm not dyin' today" ~ Tori Amos


Tomten has been doing the Lazarus cat dance back from the brink for past eight months. He was heading downhill in late June and a surgery was performed hoping the granulomas were from a foreign body like string. However he crashed after the surgery and was very poorly for several weeks.
"Tomten continues to fight but is growing steadily weaker. He has taken to spending the entire day in a pile of stuffed animals in the kids play room. My husband can get him to eat a little bit. He is becoming wobbly on his feet. My husband is still hopeful and when he eats I am too but in my gut I think he is in his final weeks."
But his vets didn't think he was in pain, didn't toss in the towel and a week later on July 26th he turned the corner with last ditch antibiotics, steroids and high energy paste.
 Cassie wrote - "I am scared to to even post this in case it jinxes us but Tom has had a great two days. Since going on the last ditch antibiotics and back on pregnazone (sic) and the high calorie paste he is feeling so much better. He is eating!! He is hanging out with us and Gizmo instead of hiding in the stuffed animal pile. When he got sick last year we did 3 things. Interferone, prednasone, and a course of antibiotics for the herpes which was bad. Since surgery Tom was off the pregnazone and he had antibiotics on the operating table but none since. Keeping my fingers crossed he is turning a corner but too scared to hope. Is it possible he has 18 lives?"
I wonder if I've been underestimating the support antibiotics can provide an ailing cat - even if it's not the primary illness, knocking down the numbers of bacteria multiplying out of their normal range due to host debilitation, may allow the cat enough space to muster his reserves for the fight. "lipo polysaccharides (LPS ) from many bacterial species will initiate acute inflammatory responses in mammals". Maybe we should have tried harder with Mishka's lump.

So his ultrasounds didn't show any other lumps - he went back to happy and active. And Cassie was back to square one diagnostically.
"He continues to do well since the antibiotics and the return to Pred. I caught him playing kitty smack down with Gizmo last night first time in 3 months. I don't know who was happier Gizmo or me. I think Gizmo was letting him win since he out weighs Tomten 3 to 1 at this point. Tomten couldn't have a more loving brother. Now that I have him back again my thoughts are turning to how do I keep him alive and delay the granulomas from coming back. I started doing some internet research trying to figure out what besides FIP causes granulomas and responds so dramatically to antibiotics and prednisone. I came across Inflammatory Bowel disease (IBD). The literature says its rare but can cause granulomas."
 Some informational links and my thoughts on IBD and inflammation:
  • http://feline-nutrition.org/health/feline-inflammatory-bowel-disease-nature-and-treatment - My gut feeling (haha a pun) is that Feline Irritable Bowel its not far off human IBD. What you eat determines the gut microbiome. We have a little human friend who had to have a fecal transplant to get rid of his awful colitis. He is a very sick boy who is now off all his meds! Anyone with Crohn's disease or colitis who wants to get cured contact Dr Borody in Sydney.
  • http://www.2ndchance.info/inflambowelcat.htm Although i dont have direct cat experience with IBD per se I noted our other pets have better skin on a proper raw diet, which I imagine reflects the state of the gut as it is basically the same as skin - both are made of epithelial cells. Mishka was the big diet fail - i always thought she'd come a cropper on dry food diet but figured (wrongly) I had time to transition her to a 'better' diet. Wrong again - commercial petfood is just wrong, I had no idea it was all so dreadful until she got ill. Now i know even the tinned food, though 'complete', is still highly inflammatory.
  • http://raypeat.com/articles/nutrition/carrageenan.shtml  - carageenan is seaweed - not meant to be eaten by cats but it's the thickener in most commercial petfood. It is known to incite inflammation, in fact it's used experimentally to do just that when you need to make a wound to test a cure on!  I have no idea why they dont use gelatin instead, which is anti inflammatory and being connective tissue supplies all the right things for building connective tissue for both humans and animals http://raypeat.com/articles/articles/gelatin.shtml
 

Friday 28 February 2014

New Year

"The act of rallying forces on behalf of creation and beauty is a declaration of one's existence in the face of a seemingly indifferent ocean of reality." ~ Andres Amador

Finding this beautiful beach art by Andres on facebook felt so right today as the Chinese New Year begins and I mark a year since Mishka died. Time to reflect, clear the house, my thoughts, tidy this blog. This is my first post for a long time - months of battling to import polyprenyl for other cats, months of quietude and healing, and months of rebuilding what had to be neglected to care for Mishka. Her 'big brother' has finished school and left home too - it's been getting very quiet here.  Bad news below - Tomten continues to deteriorate; though it's balanced by more good news from Dusty's mum who wrote to say he continues well, and from Tam's mum to say she also is fine. See their stories on the'survivors' page.
"Tomten Update - I apologize for the radio silence its been a crazy couple of months at work. Wanted to let everyone know that Tomten continues to hang in there. I am almost worried that if I post that good news something else will happen to change that status. He has his good days and his bad days. He can't jump up counters any more but he still likes cuddling and eating table scraps. Though he is really thin! He is on three different meds. Lacix plus another heart med whose name I forget and Pred.For those that don't know me. Tom was diagnosed two years ago with Dry FIP. After a year of feline interferone injections we had flown in from the UK he developed more Granulomas. After surgery to have them removed. (They where about to perforate his bowl.) We discovered no sign of Corona virus and he is believed to be suffering from an unknown auto immune disease. Last November we discovered his heart was the latest to be effected. But he is hanging in there." - Cassie