Hi everyone. I’m posting here because I’m very worried about FIP and would really appreciate input from people who have experience with FIP cases.
My cat is a young female, 8 months old, around 2.6 kg right now. We are in Scandinavia. She is already under veterinary care and has been referred to a GI/internal medicine specialist, but the appointment is several weeks away.
I am not asking for a diagnosis online. I’m mainly trying to understand how strongly FIP should remain on the list of possibilities, and whether there are specific tests or next steps I should discuss with my vet while we wait.
She has had chronic loose stool/diarrhea for about 2 months. The stool is often very soft, sometimes with mucus, but I have not seen obvious blood. She does not vomit. Her appetite has been up and down (mostly down), and her weight has fluctuated.
When things got worse, she weighed around 2.5 kg. She was started on prednisolone and Mirataz. During the first week, she improved a lot: she ate better, seemed happier, gained weight up to around 2.8 kg, and her stool started to look slightly more formed.
Now, during the last 4–5 days, she has declined again. She is back down to around 2.6 kg, has reduced appetite again, and is going to the litter box several times per day. She still plays and can seem fairly bright, but she has episodes where she seems uncomfortable, lower in energy, and possibly painful in her abdomen.
We also worry she may have intermittent fever because she sometimes feels warmer than normal, but we have not been able to confirm this. Taking a rectal temperature has not been possible because she becomes extremely distressed when anyone tries.
She is currently on day 14 of prednisolone and has also been given Mirataz. She is eating only a hydrolyzed hypoallergenic diet right now.
Clinical signs:
- Chronic diarrhea/loose stool for about 2 months
- Sometimes mucus in stool
- No obvious blood
- No vomiting
- Reduced appetite again
- Weight loss after initial improvement
- Several litter box visits/bowel movements per day
- Suspected abdominal discomfort
- Possible intermittent fever, not confirmed
- Still playful/bright at times, but had down days too
Tests done so far:
Fecal/parasite testing:
- Currently negative for parasites, including Giardia, Tritrichomonas, Cystoisospora/coccidia, Cryptosporidium, Toxoplasma, Toxocara and other worms/parasites included in the panel
Respiratory/eye/oral infectious PCR testing:
- FHV-1 / feline herpesvirus PCR: negative
- Feline chlamydiosis / Chlamydia felis PCR: negative
- FCV / feline calicivirus RT-PCR: negative
CBC:
- WBC: 24.58, reference 2.87–17.02 — high
- Neutrophils: 17.50, reference 2.30–10.29 — high
- Monocytes: 1.14, reference 0.05–0.67 — high
- RBC: 9.25, reference 6.54–12.20 — normal
- Hematocrit: 0.348, reference 0.303–0.523 — normal
- Hemoglobin: 125, reference 98–162 — normal
- Platelets: 546, reference 151–600 — normal/high-normal
- Plateletcrit: 0.89, reference 0.17–0.86 — slightly high
Chemistry:
- ALT: 686, reference 12–130 — very high
- Globulin: 53, reference 28–51 — slightly high
- Albumin: 28, reference 22–40 — normal
- A/G ratio: 0.5
- SDMA: 15, reference 0–14 — slightly high
- Creatinine: 76, reference 71–212 — normal
- Urea: 7.0, reference 5.7–12.9 — normal
- Phosphorus: 2.27, reference 1.00–2.42 — high-normal
- Bilirubin: 5, reference 0–15 — normal
- ALP: 66, reference 14–111 — normal
- GGT: 0, reference 0–4 — normal
- Amylase and lipase were within reference range
Abdominal ultrasound:
The ultrasound report described mild changes in the duodenum, possibly suggesting enteritis. The colon had mild changes consistent with colitis. The gallbladder wall was mildly thickened/hazy, with differentials including cholangitis or gallbladder wall edema. Some intestinal lymph nodes were mildly enlarged and thought to possibly be reactive. Liver, pancreas, kidneys, spleen, adrenal glands, urinary bladder and the rest of the GI tract were reported as normal.
Why I’m worried about FIP:
I’m worried because she is young, has chronic GI signs, weight loss, inflammatory bloodwork, slightly high globulin, an A/G ratio of 0.5, possible intermittent fever, and she improved at first on prednisolone but is now declining again.
Our vet has said FIP is not their first suspicion because she is still fairly bright and playful at times, but I know FIP can be difficult to diagnose and I’m scared of missing it.
My questions:
- For those with FIP experience, how concerning does this look for possible dry FIP?
- Does an A/G ratio of 0.5 with only mildly high globulin fit FIP, or is that more often nonspecific inflammation?
- Can FIP present mainly as chronic diarrhea/colitis-like signs without obvious fluid buildup, jaundice, eye signs or neuro signs?
- Does improvement on prednisolone followed by decline make FIP more or less likely, or is that not helpful?
- How worried should I be about the ALT of 686 in relation to possible FIP, especially since bilirubin, ALP and GGT are normal?
- What FIP-related tests would be reasonable to ask my vet about next while we wait for the specialist? FCoV antibody titer? FCoV PCR? Repeat CBC/chemistry? Serum protein electrophoresis? Other inflammatory markers?
- At what point would you consider this urgent enough to push for emergency/internal medicine care sooner?
I know nobody can diagnose FIP from a Reddit post. I’m just trying to understand whether I should be pushing harder for FIP investigation now, or whether this sounds more like another GI/inflammatory condition.