Evaluating Readiness to End Treatment
Determining if a patient is ready to complete treatment after 84 days or after extended treatment requires taking both clinical and diagnostic information into consideration.
It is extremely important that the entire picture of the cat's health be considered rather than assigning undue weight to any one slightly anomalous value on bloodwork.
A CBC and chemistry panel is recommended. Ideally, markers for FIP should return to within normal limits:
- Anemia: Should be resolved.
- Lymphocytosis: Often noted due to immune activation; can be safely ignored.
- Eosinophilia: Frequently noted; not associated with relapse.
- Hyperbilirubinemia: Should be resolved.
- Globulins: Within normal limits (mild elevation doesn't always correlate with relapse).
- A/G Ratio: 0.7 or higher is desirable, though some cured cats stay lower.
*Abnormal values from comorbid conditions (like stomatitis) are of less concern.
Unless there is a specific concern, these are neither required nor recommended at the conclusion. Residual small amounts of fluid or vague irregularities are often signs of past damage rather than active disease.
The cat should show outward manifestations of health:
- Resolution of neurological and ocular symptoms (keeping in mind residual damage).
- Normal (or above normal) energy level.
- Normal appetite.
- Consistent weight gain.
If criteria are not met, it is recommended to increase dosage and extend treatment by a minimum of 4 weeks.
Antiviral resistance is indicated by no response or a pattern of initial response followed by relapse. Switching antivirals may be necessary.
If concerns are minimal, a 2-week trial at a higher dose can be done. If no improvement is seen, it may not be active FIP.
Once treatment ends, observe for 3 months (Observation Phase). A checkup and bloodwork are recommended every 4-6 weeks during this period.
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