An update on Feline Infectious Peritonitis (FIP)

Host:

Welcome to the Bova UK Podcast, where we discuss diseases from diagnosis through to management. These podcasts are aimed at registered veterinary surgeons and veterinary nurses. If you’re listening as a pet owner, please consult your local veterinary surgeon if you have any concerns about your animal.

Today’s episode is an update on Feline Infectious Peritonitis (FIP), a condition that has seen remarkable developments in treatment over the past few years. We’re fortunate to be joined by Dr. Emi Barker and Dr. Sam Taylor—both experienced specialists in feline medicine and active contributors to the FIP Advice group. They’ll be discussing diagnostic challenges, current treatment strategies, and how to support both patients and clients through an FIP diagnosis.

Emi:

The past couple of years have truly transformed FIP from a fatal disease to one with a realistic chance of cure. Since the legal availability of antiviral treatments in the UK in late 2021, we’ve seen dramatic improvements in survival outcomes.

Sam:

Absolutely. It’s been amazing to see the impact of these drugs. But while they’re effective, they’re also expensive, so we need to be really thoughtful about when and how we use them.

Emi:

Let’s start with diagnosis. Not every case needs to be referred, especially the straightforward effusive ones. But we do need to confirm our suspicions as much as possible within financial constraints. Cytology and PCR or immunostaining of effusion samples can provide strong diagnostic support. And in more complex or non-effusive cases, especially those with neurological signs, referral can be appropriate.

Sam:

I agree. And it’s vital to explain to clients that treatment trials sometimes begin before we have definitive results. But we need to be careful—FIP mimics other diseases, and not every cat with effusion has FIP.

Emi:

Exactly. Skipping tests to save money can be risky. They’re often a small percentage of overall treatment cost, and false assumptions can lead to inappropriate treatment.

Sam:

When it comes to monitoring, I always emphasise that owners are a key part of the team. Physical signs like weight gain and resolution of effusion are helpful, and regular blood work can track parameters like anaemia and globulins. We also consider acute phase proteins, though more research is needed there.

Emi:

Managing relapses or non-responders is tricky. In those cases, I revisit the original diagnosis, check for compliance issues, and consider increasing the antiviral dose. Sadly, some cats do not respond due to antiviral resistance or incorrect diagnosis.

Sam:

We also need to talk about the black market. Some owners still turn to illegal drugs, which come with major risks. It’s important to acknowledge that these exist while clearly communicating the safety and support advantages of licensed treatments.

Emi:

Yes, and good client communication is everything. From explaining diagnosis uncertainty to treatment expectations and side effects, setting realistic expectations is crucial.

Sam:

For cats in remission, people often ask about neutering or vaccinations. There’s no hard data, but we try to minimise stress and recommend neutering during treatment or waiting a few months post-treatment. Vaccination timing should be individualised based on risk.

Emi:

Final thoughts—this field is evolving rapidly. We’ve gone from hopelessness to hope. But there’s still a lot to learn, and collaboration between vets, specialists, and owners is the way forward.

Emma:

Thank you both. This has been an enlightening conversation and a hopeful message for the future of FIP care. And to our listeners, if you have concerns about FIP or any health issue, always consult your veterinary surgeon.