| Summary: | 碩士 === 國立臺灣大學 === 獸醫學研究所 === 99 === Feline infectious peritonitis, FIP, is an immune-mediated disease caused by feline coronavirus. Many combinations of drugs, including antiviral drugs, immune-modulator and immunosuppressive agents, were used to control the disease. However, euthanasia is still the most suggested method. The aim of this research is to evaluate of different therapeutic strategies in treatment of FIP and to state a potential therapeutic strategy.
One hundred nineteen FIP highly suspected diseased cats, presented at National Taiwan University Animal Teaching Hospital between June 2003 and May 2011, were enrolled in this study. Sixty-four cats were confirmed to have FIP via pathological confirmation after death and another two cats were confirmed with positive IFA and PCR tests, one of the two cats were further confirmed with biopsy and another is still alive. Thirteen-five of the 66 cats were selected with the criteria of survival over 2 weeks and algorithm of the disease staging and therefore included in the analysis. Antiviral drug (nelfinavir): there was no difference in hematological changes and survival time between the subgroup1a (w/o nelfinavir) and subgroup1b (w/ nelfinavir). These may indicate that nelfinavir had no additional effect in this combination. Interferon: there was no difference in hematological changes and survival time between the subgroup2a (w/ feline interferon-omega) and subgroup2b (w/ human recombinant interferon-alpha). These may indicate that different origin of interferon had no effect in this combination and no obvious side effect. ACEI (angiotensin converting enzyme inhibitor, benazepril) was first time used in treatment of FIP. We compared group1 (w/benazepril) and subgroup2a+2b (w/o benazepril), increasing of albumin and potassium were observed in subgroup 2a+2b. These may indicated that ACEI conduced to the treatment by improvement of vasculitis caused by immune-complex. The drug-combinations of group1 included prednisolone, ACEI, human recombinant interferon-alpha, and with/out nelfinavir. The other combinations were assigned to group2. The PCV, Hb, RBC counts and albumin were significantly higher and total bilirubin was lower in group1 than in group2 at 6th weeks after treatment. These indicated that the combination of group1 had better effect in improvement of anemia and leakage of protein. Besides, 3 cats with effusive FIP in group1 became non-effusive FIP during therapy indicated the potential therapeutic strategy fro FIP.
Fifty percentage of group1 survived over than 14 weeks and only 11.54% of group2, respectively. The medians of survival time were 74.5days and 27days of group1 and group2, respectively. Both Kaplan-meier survival analysis and cumulative survival rate were significant higher in group1 than in group2 (p<0.05). In effusive FIP, the medians survival time of group1 and group2 were 74.5days and 22days, respectively. Both Kaplan-meier survival analysis and cumulative survival rate were significant higher in group1 than in group2 (p<0.05).
In conclusion, improvement of anemia and albumin and increasing of Kaplan-meier survival analysis and cumulative survival rate after treatment of the combinations, including prednisolone, ACEI, human recombinant interferon-alpha, and with/out nelfinavir, showed a potential therapeutic strategy, However, more cases and further study were still needed.
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