Epidemiological and Clinical Insights from 68 Veterinarian-Reported Cases of Feline Infectious Peritonitis During the...

In 2023, Cyprus experienced a large-scale epizootic of feline infectious peritonitis (FIP) temporally associated with the emergence of a novel feline coronavirus, FCoV-23. While molecular investigations have elucidated the recombinant origin of FCoV-23, field-based clinical and other epidemiological data from FIP cases reported during the epizootic period were needed to characterize the outbreak better. A prospective study was conducted using a structured 31-item questionnaire embedded in veterinary management software to characterize FIP cases diagnosed during the epizootic period (late 2022-2025). Data were voluntarily submitted by registered veterinarians across Cyprus. Cases were included based on a clinical diagnosis of FIP; virological confirmation of FCoV-23 infection was not required for inclusion. Data from 68 FIP cases reported by 22 clinics (response rate 21.0%) were analyzed. Affected cats were older than typically reported for FIP (mean age 3.9 years; median 3.0; range 0.4-12.9 years; SD 3.41). Most cases were documented in Limassol (51.5%) and Nicosia (25.0%). The most frequently reported clinical signs were non-specific, like anorexia (60.3%) and weight loss (54.4%), while a variety of neurological and mental manifestations were documented in 35.3% of cases. An albumin-to-globulin ratio < 0.8 was observed in 86.8% of tested cats. Antiviral therapy (GS-441524 or molnupiravir) was administered in 92.2% of cases, with reported clinical improvement of 88.9%. These findings demonstrate the value of questionnaire-based surveillance in documenting outbreak-associated FIP patterns. Although individual cases were not uniformly confirmed as FCoV-23 infections, the increased proportion of neurological presentations among FIP cases reported during the epizootic period supports previous molecular evidence suggesting that neurological involvement was associated with FCoV-23 circulation.