Periton

• Peritonitis is an inflammation of the peritoneum and is common

in horses and cattle while is less common in dogs and cats.
• Peritonitis is common in horses and cattle; It is less common in
dogs and cats.
 Periton
• It is primary or secondary according to the occurrence of peritonitis,
• It is acute or chronic depending on its duration,
• It may occur locally or widely depending on its localization,
• It is classified as septic or aseptic according to its etiology.
• According to the type of exudate, it is classified as serofibrinous, fibrinopurulent,
purulent, hemorrhagic or granulomatous.
• In domestic animals, peritonitis is mostly secondary and hematogenously.
 Periton
• A wide variety of chemicals cause chemical peritonitis. Chemical peritonitis can
also be of endogenous origin and is formed due to bile and pancreatic
enzymes.
• Medications administered intraperitoneally for treatment can usually cause mild
and insignificant peritonitis. On the other hand, in the experimental antibiotic
lavage of the abdominal cavity, destruction and adhesions in the serosa are
formed. Accidentally spilled barium sulphate in the abdominal cavity causes
hemorrhagic peritonitis, which can be fatal due to its irritative effect.
 Periton
• When bacteria reach the peritoneum by direct implantation, bacterial peritonitis
develops; This situation occurs as a result of gastrointestinal and urinary system
infections or abdominal wall perforation.
• The spread of inflammation in the abdominal organs is also among the most
common causes of bacterial peritonitis.
• Talc previously used as surgical glove powder and starch currently used for this
purpose may cause granulomatous peritonitis.
 Periton
• The consequences of peritonitis: Acute generalized peritonitis is
an important and serious complication of many local diseases in
the abdominal cavity, but it is a relatively insignificant lesion that
develops secondary to generalized infections.
• For example, peritonitis, which occurs in Escherichia coli
septicemia, or bradzo diseases, does not affect the course of the
disease.
 Periton
• In generalized peritonitis, bowel movements increase in the first few hours. In
contrast, paralytic ileus develops soon after. Occurence of ileus would be
advantageous in terms of preventing the exudate from spreading to larger areas
by bowel movements.
• However, the downside to this is that fibrinous adhesions are formed between
the intestinal loops; If the animal heals, these remain in the form of adhesions.
Adverse systemic effects of generalized peritonitis are on cardiovascular
function, circular homeostasis, and acid-base balance.
 Periton

• Feline Infectious Peritonitis (FIP)

• Feline infectious peritonitis (FIP) is an important disease of
domestic cats. It occurs worldwide in cats of all ages, but the
disease is most common in young cats less than two years of age.
Although FIP is not a particularly common disease, it is important
because once a cat develops the disease, the outcome is almost
invariably fatal.
 Periton
• FIP is associated with a virus called feline coronavirus. Cats also have a
strain of coronavirus that causes an intestinal infection.
• Intestinal infections are asymptomatic or cause mild to moderate diarrhea.
Infectious peritonitis strains have little interest in the intestines. Viruses
reproduce in macrophages, and these cells carry the virus to other parts of
the body.
 Periton
• The disease occurs almost everywhere in the world and progresses sporadically.
• Disease outbreaks are occasionally encountered.
• Mostly, the disease is more common in cats in the 6 months-3 year age group.
• Mortality approaches 100%.
• Infectious peritonitis is formed as a result of ingestion of the virus through the mouth and
nose, but mutation of endogenous enteric coronaviruses can also cause disease.
• The virus first multiplies in the tonsils or intestines, then in the lymph nodes of the region.
 Periton
• Intestinal infection causes mild atrophy of the villi.
• Macrophage infection is seen in many tissues rich in vascular or
sinusoidal circulation as a result of viremia that develops after primary
virus replication. Later secondary viremia develops associated with
infected macrophages.
• The extent of the disease and the severity of the clinical picture are
related to many factors that play a role in host-virus interaction.
 Periton
• The type and efficiency of the host immune response are important as
the virus spreads systemically through macrophages.
• The age of the animal, genetic susceptibility and immune competence,
the presence of circulating antibodies against coronaviruses, stress
factors, glucocorticoids and other causes of immune suppression,
especially the simultaneous presence of cat leukemia and immune
deficiency virus infections affect the emergence and severity of the
disease.
 Periton
• If the cell-dependent immune response is well-formed and activates macrophages,
virus replication inhibits and the disease does not occur. However, in this way, the
animals can remain persistently infected.
• Conversely, if cell-dependent immunity does not develop, the virus multiplying in
macrophages concentrates around the vessels and in the interstitium of various
seroses and tissues, causing the effusive form of infectious peritonitis.
• Effusive form progresses very quickly and results in death within 1-12 weeks.
 Periton
• Non-neutralizing antibodies to the virus form immune (antigen-antibody)
complexes. These complexes are taken up by macrophages and are
concentrated perivascularly. These complexes fix the complement and
facilitate the rapid phagocytosis of macrophages. This situation initiates
neutrophilic schemotaxis and tissue destruction. Thus, Arthus reactions
occur in the walls of small venules and arterioles in the kidney, liver and
serous membranes.
 Periton
• As a result of the Arthus reaction, a pyogranulomatous reaction occurs around the
vessels (immune-mediated pyogranulomatous vasculitis). As a result of these
vascular lesions, a protein-rich fluid leaks into the serous cavities and the effusive
form of the disease is formed.
• In the last stages of the disease, extensive intravascular coagulation and
thrombocytopenia develop due to endothelial cell destruction. Vascular lesions
cause serofibrinous and cellular exudate formation on serosal surfaces.
• Pyogranulomatous reactions around the vasculature also cause nodule formation.
 Periton
• If the cell-dependent immune response is weak or
underdeveloped, virus replication is not much;
• In this case, the non-effusive or dry form of the disease occurs. In
this form, the disease can last up to 1-6 months. However, the
effusive form of the disease is more common.
 Periton
• Feline leukemia or feline immune deficiency virus infections
negatively affect the cell-dependent immune response in animals,
leading to the formation of the effusive form of infectious
peritonitis or recurrence of the disease.
• Studies have reported that 20-50% of cats with infectious
peritonitis are infected with feline leukemia virus.
 Periton
• Effusive form: In the effusive form of infectious peritonitis, there is depression,
loss of appetite and weight loss in animals.
• Due to the accumulation of fluid, the abdomen swells. In approximately 25% of
the cases, fluid collects in the chest cavity and dyspnea may occur.
• Occasionally, fluid also accumulates in the pericardial sac.
• In contrast to the non-effusive form, eye and central nervous system findings
are not formed in this form of the disease.
 Periton
• Animals are hypergammaglobulinemic.
• Recently, leukocytosis and neutrophilia can be seen in some
animals.
• Animals may be lymphopenic if feline leukemia virus infection is
also present.
• Most of the animals die, only a few animals can recover.
 Periton
• The non-effusive form of infectious peritonitis is a chronic disease characterized by weight
loss, fever and depression.
• Relevant findings are encountered in organs where vascular lesions are formed severely.
• These include central nervous system disorders such as eye lesions, ataxia, posterior paresis,
bowing of the head, specific nerve paralysis, nystagmus (involuntary movements of the eye)
and behavioral changes, and kidney, liver or pancreatic insufficiency.
• Severe weakening is observed in cats that die from infectious peritonitis.
• In necropsy, the differentiation of syndromes is made according to the amount of serous
effusion and the distribution of inflammatory foci.
 Periton
• In effusive form, visceral lesions are sometimes minimal.
• Many effusive form cases have pleuritis with pleural effusion.
• In effusive form, up to one liter of exudate can be found in the abdominal cavity.
• In the non-effusive form, peritonitis may be mild or no change is seen on macroscopic
examination. An inflammatory reaction may occur in all seroses.
• Most animals develop peritonitis, but no significant effusion is observed in the non-effusive
form.
• Note: Effusion is an edema in the form of fluid accumulation in body cavities such as pleura,
peritoneum, and pericardium.
 Periton
• Fluid collected in the abdominal cavity is often sticky, clear and light or dark yellow in color
and may contain fibrin.
• When the seroses are covered with fibrin, they gain a granular appearance.
• Fibrin is often prominent on the visceral peritoneum and easily separable adhesions are
formed.
• There are white necrotic foci, raised plaques or nodular cellular infiltrates in the serosa; these
can travel into the organs and the intestinal walls.
• Lesions range in size from a few millimeters to 1 cm in diameter.
• Omentum adheres to other abdominal surface.
• Mesenterium thickens and becomes dull.
 Periton
• Kidneys can be enlarged and become nodular in appearance. In the kidneys, nodules of
various sizes, large and small, white in color and with a hard consistency, protrude from the
cortex.
• Varying degrees of hepatitis and pancreatitis may occur; small and white inflammatory foci are
formed in the organs. Inflammation of the tunica vaginalis results in periorchitis.
• Fibrin is relatively small in the thoracic cavity and there are hard white foci under the pleurisy.
• Hydropericardia and epicarditis are seen rarely.
• Lymph nodes in the abdominal and chest cavities enlarge and their cross-sectional faces
become lobular.
 Periton
• In the non-effusive form of the disease, inflammatory foci defined in the
abdominal and chest cavity organs may be encountered or lesions are found
in the eye and central nervous system.
• The characteristic microscopic lesion is a focal mixed inflammatory reaction
with generalized vasculitis and perivasculitis, especially in the venules.
• Eye lesions are diffuse uveitis, panophthalmitis or chorioretinitis. Fibrin is
often found in the anterior chamber.
• Note:
• Uveitis is a form of eye inflammation. It affects the middle layer of tissue in
the eye wall (uvea).
• Panophthalmitis is the inflammation of all coats of the animal eye including
intraocular structures.
• Chorioretinitis is an inflammation of the choroid (thin pigmented vascular
coat of the eye) and retina of the eye. It is a form of posterior uveitis. If only
the choroid is inflamed, not the retina, the condition is termed choroiditis.
 Periton
• Differential diagnosis:
• The effusive form should be differentiated especially from bacterial
peritonitis and pyothorax.
• Non-effusive form should be differentiated from lymphoma, steatitis, fungal
infections and toxoplasmosis.
FIP
FIP-
Focal pyogranulomatous nodules
 Feline Leukemia Virus Infection

• Feline leukemia virus (FeLV) infection is one of the most

common infectious diseases in cats, affecting between 2 and 3%
of all cats in the United States. Infection rates are significantly
higher (up to 30%) in cats that are ill or otherwise at high risk.
Fortunately, the prevalence of FeLV in cats has decreased
significantly in the past 25 years since the development of an
effective vaccine and accurate testing procedures.
• Cats persistently infected with FeLV serve as sources of infection for other
cats. The virus is shed in saliva, nasal secretions, urine, feces, and milk of
infected cats. Cat-to-cat transfer of the virus may occur from a bite wound,
during mutual grooming, and (rarely) through the shared use of litter boxes
and feeding dishes. Transmission can also take place from an infected mother
cat to her kittens, either before they are born or while they are nursing. FeLV
does not survive long outside a cat's body – probably less than a few hours
under normal household conditions.
• Cats at greatest risk of FeLV infection are those that may be exposed to
infected cats, either via prolonged close contact or through bite wounds.
Such cats include cats living with infected cats or with cats of unknown
infection status, cats allowed outdoors unsupervised where they may be
bitten by an infected cat, and kittens born to infected mothers.
• Kittens are much more susceptible to FeLV infection than are adult cats, and
therefore are at the greatest risk of infection if exposed. However, even
healthy adult cats can become infected if sufficiently exposed.
During the early stages of infection, it is common for cats to exhibit no signs of disease at all. Over time,
however, (weeks, months, or even years) an infected cat's health may progressively deteriorate or he/she
may experience repeating cycles of illness and relative health. Signs can include:

• Loss of appetite
• Progressive weight loss
• Poor coat condition
• Enlarged lymph nodes
• Persistent fever
• Pale gums and other mucus membranes
• Inflammation of the gums (gingivitis) and mouth (stomatitis)
• Infections of the skin, urinary bladder, and upper respiratory tract
• Persistent diarrhea
• Seizures, behavior changes, and other neurological disorders
• A variety of eye conditions
• Abortion of kittens or other reproductive failures
• Although a diagnosis of FeLV can be emotionally devastating, it is
important to realize that cats with FeLV can live normal life for
prolonged periods of time. The median survival time for cats
after FeLV is diagnosed is 2.5 years. Once a cat has been
diagnosed with FeLV, careful monitoring of weight, appetite,
activity level, elimination habits, appearance of the mouth and
eyes, and behavior is an important part of managing this disease.
 Feline Immunodeficiency Virus (FIV) Infection

• Feline immunodeficiency virus (FIV) is one of the most common and

consequential infectious diseases of cats around the world. In infected cats, FIV
attacks the immune system, leaving the cat vulnerable to many other infections.
Although cats infected with FIV may appear normal for years, they eventually
suffer from immune deficiency, which allows normally harmless bacteria, viruses,
protozoa, and fungi found in the everyday environment to potentially cause severe
illnesses. Though there is no cure for FIV, recent studies suggest that cats with FIV
commonly live average life spans, as long as they are not also infected with feline
leukemia virus.
• The primary mode of transmission for FIV is through bite wounds from an
infected cat. Casual, non-aggressive contact, such as sharing water bowls or
mutual grooming, does not appear to be an efficient route of spreading the
virus. As a result, cats in households with stable social structures where
housemates do not fight are at little risk of acquiring FIV infections. Only on
rare occasions, an infected mother cat may transmit the infection to her
kittens. However, if the mother becomes infected with FIV during her
pregnancy, the transmission risk to the kittens is increased. Sexual contact is
not a significant means of spreading FIV among cats.
References for digestive system pathology, pancreas,
periton, liver and biliary system pathology
1. Maxie G (Editör). Jubb, Kennedy & Palmer's Pathology of Domestic Animals. 5th
Edition, Saunders Ltd., 2007.
• 2. Sav A, Özdamar ŞO (Çeviri Editörleri). Robbins ve Cotran Hastalığın Patolojik Temeli. 7.
Baskı, Güneş Tıp Kitabevleri, 2009.
• 3. Çiftçi MK, Ortatatlı M, Erer H, Hatipoğlu F, Özdemir Ö (Editörler). Veteriner Sistemik
Patoloji. Selçuk Üniversitesi Basımevi, 2015.
• 4. Hazıroğlu H, Milli ÜH (Editörler). Veteriner Patoloji. 2. Baskı, 2000.
• 5. Metin N (Editör). Veteriner Patoloji. 1. Baskı, 2011.
• 6. Zachary JF (Editör). Pathologic Basis of Veterinary Disease. 6. Baskı, Elseiver, 2017.