Stabilization and symptomatic care play a crucial role in enhancing the outlook and ensuring successful treatment completion, even for cats in a critical state. Offering effective supportive measures, particularly during the initial stages of treatment, can significantly enhance the prognosis.
Steroid use
The utilization of short-acting steroids like prednisolone or dexamethasone SP can be advantageous in stabilizing a patient's condition before or at the onset of FIP treatment. However, it is crucial to discontinue their use once the patient starts to exhibit improvement, typically within the initial week. Prolonged administration of steroids is strongly discouraged, unless there is a clear necessity, due to several reasons:
It can mask the resolution of symptoms, particularly in cats with neurological FIP.
Once symptoms start to subside, continued steroid use offers no further benefits.
Steroid usage might interfere with the development of a protective immune response against the FIP virus.
The use of long-acting steroids, such as Depo-Medrol, is strongly advised against.
It should be noted that there are certain cases where steroid administration may be appropriate later in the treatment process, such as reducing intracranial pressure in cats with severe neurological FIP. Pleural Effusion In cases where pleural effusion is detected and the patient is experiencing difficulty in breathing (dyspnea), therapeutic thoracocentesis is necessary and highly recommended. This procedure helps relieve symptoms by draining the fluid accumulated in the chest. Unlike abdominal effusions, thoracic fluid tends to reaccumulate at a slower pace. Typically, symptoms related to thoracic effusions resolve within 10-14 days.
Abdominal Effusion Therapeutic abdominocentesis, which involves draining the fluid from the abdomen, is generally not recommended unless the fluid is compressing the chest and causing breathing difficulties. In such cases, it is advised to remove only the amount of fluid necessary to alleviate the symptoms. Abdominal effusions tend to return relatively quickly, which limits the effectiveness of abdominocentesis as a long-term solution. Repeated drainage of abdominal effusions can deplete proteins and lead to harmful imbalances in fluid and electrolyte levels, particularly in severely ill cats.
Pericardial Effusion Pericardial effusion is a relatively rare occurrence, but when present, it may require a procedure called pericardiocentesis, which involves draining the fluid from the pericardial sac surrounding the heart. Anemia Anemia that accompanies FIP is typically mild and does not usually require extensive intervention. However, in some cases, more severe anemia may necessitate a transfusion. It is important to note that cats with FIP are immunocompromised and may have secondary conditions that could contribute to anemia, such as mycoplasma infections.
The underlying causes of anemia in FIP can vary, including secondary autoimmune hemolytic anemia (AIHA) and chronic inflammation. In general, most cases of anemia tend to resolve well once treatment is started. B12 complex supplementation may be beneficial.
Inappetence and Nutritional Support
Cats diagnosed with FIP often experience reduced or no appetite. This lack of food intake can persist for several days, exacerbating the issue. Most FIP cases with inappetence can benefit from a short-term administration of anti-nausea medication and an appetite stimulant such as mirtazapine or B12 complex. Typically, these medications are required for a few days. Once the cat has started treatment for FIP, inappetence should resolve in 5-7 days.
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