Zurik’s Saliva-Spitting Technique And More About FIP

Every day, after medicines, Zurik will ask for a reward from the kitchen. His reward is Cindy’s Salmon Recipe (with chicken) kibble. This is his current favourite kibble. He eats raw chicken fillet for breakfast.

Zurik has also perfected a saliva-spitting technique because he hates having liquids syringed into his mouth. Here is how he does it: The moment he knows I am going to syringe in either RetroMAD1 or Vetri DMG, he accumulates saliva in his mouth. Then, when I syringe in the liquids, he spits out the saliva (along with some liquid). I do close his jaws after syringing, but he still manages to spit out the saliva+liquid. What I do now is to give it in small doses. Perhaps he doesn’t like it all at one go. But I use the same size syringe for Ginger’s Vetri DMG and Ginger swallows everything with NO problems.

Initially I thought Zurik didn’t like the “jet” effect of the 1ml syringe, so I switched to the 5ml syringe but it makes no difference. He just doesn’t like liquids being syringed into his mouth. Tablets are okay.

Will have to “outsmart” him, if at all that is possible….?

A vet who has a special interest in FIP has just joined in Zurik’s discussion in the FIP Advisory group and has suggested that we rule out lungworm infection. However, a quick check with Zurik’s vet revealed that there is no lungworm in Malaysia.

I was also asked to do the RT-PCR test on Zurik’s effusion and again, we do not have this test in Malaysia.

Here is a very useful link: http://www.catvirus.com/treatment.htm

This is a diagnosis algorithm:
http://www.catvirus.com/downloads/FIPdiagnosisalgorithm.pdf

Unfortunately, for Zurik, we have reached “FIP possible” and we cannot go on because we don’t have the RT-PCR test in Malaysia.

We also don’t have feline Interferon (or human Interferon) in Malaysia. Interferon is an anti-viral.

What we have is RetroMAD1 and it only has a 15-20% chance of prolonging life in FIP cases.

But the fluids being of a dark yellow shade on Wednesday already points towards FIP, so we have accepted that fact. Within only one week, it has changed from pale yellow to dark yellow. That scared me – the rate at which the disease progressed.

In the link above, you will see this:

February 2019: Dr Pedersen found the cure for FIP!

When I first came to Feline Infectious Peritonitis research, FIP was regarded as an incurable condition. Many reported “recoveries” were probably curable conditions wrongly diagnosed as FIP. However, it is my experience that if diagnosed early enough, some cats with FIP can be cured. With the introduction of feline interferon and more recently, GS-441524, the RNA nucleoside analogue, we now have hope for more than remission of weeks to months – we have hope of complete recovery for some cats, especially those diagnosed in early infection. However, more work requires to be done: even in human beings there is no reliable treatment for chronic inflammation. Therefore the emphasis must still be on totally preventing cats ever developing FIP in the first place, and on accurate diagnosis, so that cats with non-FIP conditions are not needlessly euthanised.

The use of Prednisolone

Prednisolone
Prednisolone is the main anti-inflammatory and immunosuppressant used in feline infectious peritonitis, but in the last year I have completely stopped advising this in FIP treatment and now advocate meloxicam (and Virbagen Omega) instead and my survival rates have improved dramatically.

Presnisolone is relatively safe and tends to make the cat feel better, it stimulates his or her appetite; prednisolone is inexpensive and available everywhere. However, prednisolone suppresses both the humoral and cell-mediated immune response and it is possible that alternative anti-inflammatory treatments would be more effective in the treatment of FIP: Hugo and Reading (2015) reported prolonged survival—787 days—in a 4 year old cat with effusive FIP, who they treated with meloxicam and one month of metronidazole and Tramadol.

When prednisolone is used, it is absolutely essential that the doses BE REDUCED: I am frequently shocked to learn of veterinary surgeons who forget the halve the dose of corticosteroids every 7-10 days: for example, this was not done in the Ritz study and 13 of the cats died of secondary bacterial infections.

Prednisolone has the advantage of also being the treatment for lymphocytic cholangitis, which can be mistaken for FIP, so where the diagnosis is in doubt between FIP and lymphocytic cholangitis, prednisolone can be given anyway: the cat with lymphocytic cholangitis has a good chance of recovery, the cat with FIP unfortunately will die. Prednisolone should never be used in cats with toxoplasmosis, or leishmaniasis, neither is it safe in cases of septic peritonitis or pleurisy, which is why cytology is a very important part of effusive FIP diagnosis, as there will be many more white blood cells in the effusion of a cat with sepsis, and a good cytologist will detect the bacteria or fungi.

Dose: 2 mg/kg/sid given by mouth for 10-14 days
then 1 mg/kg/sid given by mouth for 10-14 days
then 0.5mg/kg/sid given by mouth for 10-14 days
then 0.5 mg/kg every other day until recovery or death

Prednisone is not effective in cats

Meloxicam (Metacam, Boehringer Ingelheim)

Provided kidney function and blood pressure are normal, consider using the non-steroidal anti-inflammatory meloxicam instead of corticosteroids.   Meloxicam was used for 119 days, along with one month of metronidazole, in one FIP case report in a cat who survived 787 days. (Hugo and Reading, 2015) Meloxicam, rather than glucocorticoids, was also used in 10 experimentally-infected cats who recovered using an antiviral called GS-441524 (not yet commercially available). (Murphy et al, 2018)

The above is a sharing from the link. Again, best to consult your veterinarian for a diagnosis.

Since we don’t have some of the recommended drugs, we can only work with what we have.

We can work on the nutrition then.

From the link:

2. NUTRITION  – this section applies to cats with wet or dry FIP; FCoV associated diarrhoea and asymptomatic healthy FCoV infected cats

The beauty of altering nutrition immediately is that it will help in any condition, not just FIP—and it is safe.  If you have read The China Study, watched Forks Over Knives, or heard Dr Michael Greger’s famous top human killer diseases lecture, you will already be familiar with the enormous impact diet has on preventing, and even curing, most of the main reasons for human deaths – the situation in cats and dogs may well be similar.

It is my opinion that feeding as varied and natural a diet as possible to cats with FCoV infection and FIP is essential: avoiding highly processed, pro-inflammatory grain-based commercial foods (even the expensive so-called “veterinary” diets are usually cereal based). 

Unlike humans, arginine is an essential amino acid in the cat (Morris & Rogers, 1978): this is why they are obligate carnivores. Arginine is essential not only for the urea cycle but also for the normal functioning of monocytes and endothelial cells. To see an animation of feline coronavirus infecting a monocyte/macrophage, and wet FIP developing, visit: http://www.youtube.com/watch?v=6RyI2LI9R9Q

Give real meat daily to augment arginine levels: even just a tablespoonful a day will make a difference to FCoV infected cats.  It is important that the meat or liver come from free range animals because they will have eaten grass which is rich in omega 3. Alternatively, regularly use commercially available real meat based cat foods e.g. Applaws (MPM products, available from the Zooplus website in Europe); Wild Kitty Cat Food. 

Feed cats with FIP a little salmon, sardines, pilchards or other fish rich in omega 3
Increase the anti-inflammatory omega 3 fatty acid content of the cat’s diet (i.e. add sardines, pilchards, salmon, mackerel twice a wk for 6 weeks). Both Applaws and Almo Nature have canned food including real fish. However remember the risk of hypervitaminosis A (excessive laying down of bone at the joints) so be wary of feeding too much real fish – reassess the situation after 6 weeks.

Cereal based foods contain too much omega 6 polyunsaturated fatty acids and too little omega 3, leading to a state of chronic inflammation – we have seen this in human beings over the past couple of decades: an unprecedented rise in inflammatory conditions such as allergies, asthma and arthritis.  We see a similar rise in inflammatory conditions being recognised in the cat.  

Remember to instruct the cat’s guardian in a gradual changeover of the food: to change it over a period of weeks otherwise the cat will wolf down the new food for a few days, then get sick of it and never touch it again!  The way to introduce a new food is to give it for one meal, then go back to the customary diet for the next few meals, then give a little of the new food again, and so on, gradually increasing the frequency of the new foods, until giving a different food every meal becomes the norm for the cat.  To introduce new foods gradually properly will take at least a month.  

FCoV associated diarrhoea helped by chicken and pumpkin cat food
I’ve had remarkable success using Applaws or Almo Nature chicken and pumpkin tinned food in these cases.

Zurik gets raw chicken fillet every morning and whenever he likes. He also gets fish oil (omega 3). I give him steamed sardines too.

But Zurik is a kibble-king (like Indy), so I am ordering high-protein kibble for him as well. I know processed food is the last thing on a cat’s diet, but we are at a point where Zurik is living on borrowed time, so it is more important that he eats.

For me, the most important thing is that Zurik is happy.  If he loves eating kibble so much, I will give him kibble.

Source: https://myanimalcare.org/2019/04/27/zuriks-saliva-spitting-t..

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