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

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.

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

 

Tam

Tam is a beautiful "Neva Masquerade" or "Colour Point Siberian" who is currently in remission from possible wet FIP (lung) living in France with Virginie. At the end of January 2013  6 month old Tam was diagnosed by her regular vets with wet FIP.  FIP specialist Dr Addie is in France and she is also consulting on the case.
Tam had trouble breathing and a high fever up fever up to 40°C. Her lungs were full of filthy lemon yellow liquid drained twice in 3 days. Amazingly she responded rapidly to antibiotics and prednisone, looking quite well by day 5, and perfectly healthy by day 18.  As you can see Tam is still a picture of health and beauty in April.

Happy May 1st ("Lily-of-the-valley" day for us in France) from Tam!

As usual poor Virginie went through the terrible agony of despair and uncertainty of how to proceed surrounding a diagnosis of FIP which I hope to help ease by chronicling some cases. There are some differences in Tam's presentation to Mishka's which I'll list later.

The Siberian is one of the 3 forest cat breeds that were originally wild breeds from Russia. From Tam's case I have also learned of the new Russian drug Skulachev ions (Visomitin, SkQ1)and eventually also found exemplary breeders Forest Wind who provide a 10 year genetic health guarantee including for FIP! (See breeders database for contact details.) Tam had four and a half shots of Feline Omega Interferon,  a lot of raw beef and is on two drops daily of "Skulachev ions" which are a targeted mitochondrial antioxidant currently used for human eye diseases in Russia. (A similar item Mitoquinone is more frivolously applied to the face to cure wrinkles by the New Zealanders. The lower regulatory hurdles for cosmetics allow the fast tracking i suppose.) Her latest blood tests show significant drop of the AGP level ( a non-specific marker of inflammation raised with infection) compared to 3 months ago.

Virginie tells her story:

Tam, a female 6 months-old kitten is healthy, but little bit more tired as usual. Breath seems heavy. 10 pm, we're trying to think this could wait open hours, but no, something is not right, we went to vet emergency : fever is there, and liquid in chest too.
the day after (saturday), x-rays confirmed the pleural effusion. On Monday (day + 3), we sent blood and pleural liquid to the Vet. University of Glasgow for a FIP profile.
Results are "clear" : for my vets, FIP is confirmed. So prednisolone + antibiotics in routine treatment for supporting the kitten.

Last week X-rays (day + 10) shown improvement : liquid is still there, but far reduced.
At day+18, Tam is as healthy as a kitten could be, ... running in the garden, purring on our laps, eating a lot, fighting with our 6 others cats (all have been coronavirus tested, and are negative to mild-loaded).

We are waiting to start feline interferon treatment (the bottle is ordered)
Or is it something else as FIP-cats are not likely to run the way she is (according to other breeders I asked for advices) ???

There was no bacterial culture of the effusion sample sent to Glasgow University for a FIP profile as suggested in the comments of the lab report so some question marks remain as to whether she had a bacterial infection since there was a high white cell count seen. Dr. Diane Addie has slight reservations about the diagnosis of wet FIP (perhaps based on Tam's speedy response to antibiotics and prednisone?) Tam's own vets are sure what they saw in January was a kitten with wet FIP.  "at that time, we were convinced it was FIP and no hope left, we didn't ask [for the culture]. Later when Tam was so well, it was too late : no more liquid remained (no more in Glasgow, and no more in Tam's lungs !)" The vets nicked a vein when drawing off the effusion, so Virginie says a little bit of blood may be the cause of the high cell count but personally I have reservations about the logic. Looking at it the white cell count seems too high compared to the red to be from simple contamination. Also really if they were so sure it was FIP then why send off an effusion sample all the way to another country for an expensive test? and furthermore especially  on a tight budget wouldn't it make more sense to go for the bacterial culture because you'd have a fighting chance of a good outcome if you treated for it? They gave Tam antibiotics for FIP - I'd think they'd want to be sure it was the right one, or is that just the standard response for a cat with a fever? Mishka had the high fever and mild cold like illness months before she got fluid in the lung (and belly.) At that stage there was nothing to culture except perhaps a straight blood sample. She spent a night at the vet's and was given a shot of a long acting antibiotic.  Months later when she presented like Tam with a day's worth of extreme difficulty breathing the vet drained the chest urgently - it was a transparent fluid amber tinged with blood from the needle. She analysed Mishka's effusion sample in house for cells and protein. Based on that excluded infection - she didn't request the sample be sent for further testing.

From what I can gather Tam only had 4 and a half doses of interferon beginning mid February spaced a week apart starting before being pronounced "in remission". Although Virginie says her vet is following the Isheda protocol it doesn't sound like it to me as that protocol begins with second daily injections. She wrote: 

March 16 Thanks. By now, Tam is still perfectly well. She received her 4th weekly interferon injection last saturday. Dr Addie adviced to continue interferons once a week ; but my vets told the published use of interferon is only 4 injections, and preferred to stop the interferons, to re-do a series in few months if needed. I really don't know what to do !!!

nothing has been published yet on the use of interferons in FIP cases : the manager knows about Dr Addie and Dr Jacqui's work, but as nothing has been validated, and against the lab commercial interests, she advised my vet not to continue interferon (because Tam is asymptomatic ; she is "completely OK", no sign at all of any FIP matter), and to re-do if needed later.

March 20 I was in touch with Diane Addie (I'm currently trying to translate the fip-book in French) ; the problem is that cases of remission already happened in the past without any interferons - and failures with interferons too : so it is difficult to affirm that interferons are really the key.
I read about Ishida and german study. I guess interferons may help, but just help, not cure. I also have to take in account that going to the vet weekly is a trial for Tam : this will not help her, for sure (as soon as she sees the crate Tam is hiding deeply, running into a rush - she really suffers to go to the vet, I think she had a bad experience during her transport from her board cattery to my home, and it is not the time to re-educate her right now).

Money is not really the problem: I want to be sure this would be really useful.

She is doing well for 2 months now, there is no difference before/after these 4.5 (she received what remained in the bottle last saturday - just half a dose) injections of interferons. I even don't know if these made her good or not : there has been no improvement, as there was nothing to improve (she already looked like she was healthy five days after the first "FIP-day").

I'm not that convinced interferons are key in FIP case. Tam is eating a lot of raw beef, I wonder if this is not better.
We did 4 interferons injections (once a week) current march (she was still "healthy" before we started - actually, she was ill only few days, she soon got better, and better, despite her results at FIP-profile ).

On Dr Addie advice and with her help, we've just started to give Tam some "Skulachev ions" ; we asked for FIP-profile at Glasgow vet university just before we started, so maybe we could see a difference between before/after.

Yes there was a big difference,

• from Alpha-1 AGP  2240 in Jan 
• to 540 before SkQ1 
• then 500 which is normal on april 22nd (after 15 days of skulachev ions) and Albumine/Globuline is 0.84

Even though AGP is not a specific FIP marker ( it is raised with other infections ) it is great news consistant with recovery - way to go Tam! Virginie says "Champagne!" Take home message may be that we are in danger of giving up too easily once the idea of FIP is on the table; repeated drainage and at a pinch it seems prednisone, antibiotics and don't forget the raw beef, are potentially able to cure something + they are cheap. Even interferon added to the mix did no harm to Tam. "I cannot affirm interferons, or skulachev ions have cured her; my opinion is that Tam has recovered on her own, we've just helped her. I cannot affirm either Tam is cured ; she is still here 4 months later, growing, eating, playing and her results are very encouraging, that's all"

 Update March 2014 A year later Tam is still alive and well.

Her photo also reminded me of FIP's link to another lovely spring flower, the snowdrop, Galanthus Nivalis which may hold a cure for both FIP and cancer. see 'treatment' page.