VN August 2022

Vetnuus | August 2022 10 The owners continuedmedicatinghimat homewithnoother intervention necessary. Routine follow-ups were performed at four weekly intervals, with clinical improvement and improvement in haematological and biochemical parameters. By week 12, when treatment was due to stop, Squirrel had gained 1.7kgwith a BCS of 6/9. His uveitis had cleared entirely, as well as all neurological deficits. He was clinically normal in all ways. His haematocrit had increased to 33% on haematology, with a normal leukocyte count and a lymphocyte fraction of 20%. His albumin was 26g/l and globulins were 47g/l, with a ratio of 0.6. All other biochemical parameters were normal. A breathtaking change was seen on abdominal ultrasound, with the improvement of the kidney lesions being the most prominent. Two years after the end of treatment, Squirrel is alive and healthy. Case Study: Raven Raven, a nine-month-old male, castrated, domestic shorthair, presented after being diagnosed with FIP at his primary vet, based on signalment, clinical signs and appropriate blood work. He had been syringe-fed for the past three weeks and treatedwith prednisolone. On presentation, Raven was emaciated, with BCS 1/9, and overall, small for his age. He was severely dehydrated (based on a weight gain of 12%when rehydrated), and mucous membranes were pale. Raven was tachypnoeic, tachycardic and hypothermic on presentation (35.8’C). He presented with iritis and later developed a severe keratitis. He was pareticandonlyabletolifthishead.Hewasurinaryandfaecallyincontinent. Twelve hours after presentation, Raven started to seizure. On haematology, Raven had severe non-regenerative anaemia (Ht 16%), mild non-degenerate neutrophilia (14.25 x 10 9 ), and low normal lymphocytes (0.8 x 10 9 ). Biochemistry showed mild hyperglycaemia, likely due to stress, with lownormal albumin (25g/l – however, this was probably higher due to severe dehydration) and a hyperglobulinaemia (70g/l), giving a ratio of 0.4. ALT and ALKP were both raised (212U/L and 117U/L, respectively).Creatininewaslow,reflectingseveremusclewasting.Thoracic radiographs showed lesions suggestive of pulmonary granulomas. An abdominal ultrasound showed enlarged abdominal lymph nodes and hypoechoic subcapsular halos, with hypoechoic lesions within the kidneys – a classical FIP granuloma appearance. Ravenwas startedon a locally compoundedGS-441524 injectable product at 10mg/kg. Hewas started on Levetiracetam to control seizures and given supportive treatment of B12, anti-emetics, and SAMe. He remained critical for several days, withhis haematocrit dropping to 12% on day five. He hadmore seizures on days two and three of treatment. Nutritional support was maintained via a nasoesophageal tube. Over the next two weeks, he gradually strengthened, partially regained bladder and bowel control, and started eating by himself. He was discharged on continued therapy with GS-441524 and SAMe. Leading Article Keratitis of the left eye Iritis of the left eye Squirrel right kidney, after 12 weeks treatment Squirrel at 2 year follow-up Raven shortly after presentation