一例猫传染性腹膜炎前驱期的诊断与治疗

Diagnosis and Treatment of a Cat with Prodromal Feline Infectious Peritonitis

摘要: 猫传染性腹膜炎(feline infectious peritonitis, FIP)是临床常见且诊断难度较高的猫科疾病，早期症状多缺乏特异性，易与其他消化系统或感染性疾病混淆。本文报道1例6月龄雄性狸花猫FIP病例。患猫以呕吐、食欲废绝、精神沉郁及眼睑黏膜淡黄为主要表现，就诊初期尚未出现明显腹水。经临床检查、血常规、生化、血清淀粉样蛋白A (serum amyloid A, SAA)、猫瘟筛查、腹部X线检查及后续腹水PCR检测综合分析，最终确诊为猫传染性腹膜炎。治疗上，在补液、营养支持、抗炎及保肝退黄等对症治疗基础上，给予GS-441524进行对因治疗。治疗30 d后复查显示，患猫精神状态、食欲及体温恢复正常，血常规基本恢复正常，生化指标除总胆红素仍轻度升高外，其余明显改善。结果表明，对于出现发热、厌食、精神沉郁及黄疸等非特异性症状的幼猫，应重视FIP的早期鉴别诊断，并结合动态病程观察和实验室检查尽早确诊，以提高治疗效果并改善预后。

Abstract: Feline infectious peritonitis (FIP) is a common feline disease in clinical practice and remains challenging to diagnose because of its nonspecific early manifestations, which can easily be confused with other digestive or infectious diseases. This paper reports a case of FIP in a 6-month-old male Chinese rural cat. The cat presented with vomiting, complete loss of appetite, depression, and mild yellow discoloration of the palpebral mucosa, without obvious ascites at the initial visit. Based on clinical examination, hematological and biochemical analyses, serum amyloid A (SAA) testing, feline panleukopenia screening, abdominal radiography, and subsequent PCR testing of ascitic fluid, the cat was finally diagnosed with feline infectious peritonitis. In addition to symptomatic and supportive treatment, including fluid therapy, nutritional support, anti-inflammatory therapy, and hepatoprotective treatment for jaundice, GS-441524 was administered as etiological therapy. Reexamination after 30 days showed that the cat’s mental status, appetite, and body temperature had returned to normal; routine blood parameters had basically normalized; and biochemical indices had markedly improved except for a slight persistent elevation in total bilirubin. This case suggests that FIP should be included in the differential diagnosis in young cats presenting with nonspecific signs such as fever, anorexia, depression, and jaundice. Early diagnosis based on dynamic observation of disease progression combined with laboratory examinations may improve therapeutic efficacy and prognosis.