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貓之傳染性腹膜炎
建立日期: 2012/10/9
更新日期: 2012/10/18
更新: 許如瑩;賴政宏;鄭豐邦
中文病名: 貓之傳染性腹膜炎
英文病名: Feline Infectious Peritonitis
疾病描述:

傳染性腹膜炎是由冠狀病毒(feline coronaviruses, FCoV)感染之致死性疾病。依照是否產生體腔滲出液分成溼型(滲出型)及乾型(內臟結節型)兩種。急性滲出型起因於病毒攻擊血管壁造成急性炎症反應,大量滲出液的產生蓄積於體腔中,患可能因胸水或腹水而造成呼吸困難;慢性結節型引發的慢性炎症反應則於各臟器形成化膿性肉芽組織結節,常見有腸系膜淋巴結、肝臟及腎臟,進而導致黃疸。部分乾型病例也見神經系統及眼部傷害,而有神經症狀葡萄膜炎。約有四分之三感染隻為溼型,但溼型也可能轉變為乾型,或兩型同時存在,其中溼型的死亡率又較乾型高。

病因:
冠狀病毒可分兩型:傳染性腹膜炎病毒(feline infectious peritonitis virus, FIPV)和腸型冠狀病毒(feline enteric coronavirus, FECV)。FIPV可能由FECV變異而來,但是有FECV的隻是否會發展成FIP,則和宿主對病毒的反應能力有關。FIP對隻為一高致死率疾病,而FECV感染則通常沒有臨床症狀,或只是輕微的嘔吐下痢,胃腸炎,目前的臨床檢驗方式尚無法區分出兩種病毒的感染,且FECV在群聚飼養隻身上也相當常見。FIPV經由糞、尿和口鼻分泌物進入體內,在和抗體結合後會藉由endocytosis進入macrophage或monocytes 中複製,受感染細胞遭免疫系統作用時反而會釋出更多病毒,且其引發的免疫反應使周邊血管因炎症而受損,故各臟器皆可能有病變產生。

臨床症狀:
FIP在臨床上,可見漸進性的精神不振、食慾減退、體重下降和抗生素治療無效的慢性波狀熱等症狀,且多於年幼隻感染。隨著病毒攻擊不同器官, 脂肪肝黃疸嘔吐下痢等也可能發生。

預防控制方法:

因本病毒在群體飼養隻中很常見,故須避免 群體飼養及共用砂盆,以免經糞尿途徑感染。在隻身上檢驗出病毒陽性未必會發病,故減少環境壓力及提供適當營養也可避免臨床症狀出現,其他傳染性疾病的 感染也會增加發病機會。幼常攜帶本病毒,應在血清學檢驗陰性後才與其他隻共同飼養。

相關圖片:
This necropsy picture shows an enlarged mesenteric lymph node. Below it you can see the inflammation that has occurred on the outer surface of the intestines
This autopsy picture shows a reaction on the surface of the liver. This reaction is called pyogranulomatous, and is the basis for the diagnosis. 圖片引自http://www.caminoanimalclinic.com/library/fip.html
參考文獻:

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8.Paltrinieri S, Grieco V, Comazzi S, Cammarata PM. Laboratory profiles in cats with different pathological and immunohistochemical findings due to feline infectious peritonitis (FIP). J Feline Med Surg 3: 149-159, 2001.
9.Pedersen NC. A review of feline infectious peritonitis virus infection: 1963-2008. J Feline Med and Surg 11: 225-258, 2009.
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參考連結: