Diagnosing FIP in the era of treatment: which tests are most important?

Overview

The availability of effective antiviral treatment has transformed feline infectious peritonitis from an almost invariably fatal disease into one with an excellent chance of recovery. However, diagnosing FIP remains challenging. There is no single, minimally invasive test that reliably confirms or excludes FIP in every cat and delaying treatment while pursuing absolute diagnostic certainty may adversely affect the outcome. This practical webinar will present a structured approach to diagnosing FIP in the treatment era.

We will examine how signalment, clinical presentation, routine laboratory abnormalities and diagnostic imaging influence the pre-test probability of FIP, before considering which specific tests provide the greatest diagnostic value. Particular emphasis will be placed on choosing the most informative sample. When an effusion is present, analysis of that fluid- including cytology, protein assessment and detection of feline coronavirus RNA – is usually considerably more useful than testing blood. In cats without effusion, targeted sampling of affected organs, lymph nodes, or cerebrospinal fluid may be required.

The webinar will discuss the interpretation and limitations of commonly requested tests, including albumin-to-globulin ratio, acute-phase proteins, Rivalta testing, feline coronavirus serology, RT-qPCR and coronavirus mutation analysis. We will also consider when a negative result does not exclude FIP, and when a carefully monitored treatment trial is reasonable. By the end of the session, delegates should be able to select diagnostic tests based on the individual cat’s presentation, interpret results within the context of disease probability and make timely, evidence-based decisions about initiating antiviral treatment.

Learning outcomes:

After attending this webinar, participants should be able to:

Recognise clinical presentations and routine laboratory findings that increase or decrease the likelihood of FIP.
Select the most diagnostically useful sample according to whether the cat has effusive, non-effusive, ocular or neurological disease.
Explain the diagnostic value and limitations of commonly used tests, including albumin-to-globulin ratio, acute-phase proteins, Rivalta testing, coronavirus serology, RT-qPCR.
Interpret positive and negative feline coronavirus test results in the context of sample type, disease prevalence and pre-test probability.
Decide when the evidence is sufficient to initiate antiviral treatment and how response to treatment should -and should not -contribute to the diagnosis.