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January issue /2022

IS FELINE INFECTIOUS PERITONITIS A DISEASE FINALLY CURABLE?

FIP is one of the toughest diagnoses in the veterinary clinical practice!

FIP is a nightmare disease for any veterinarian. FIP makes us feel helpless, incapable, and always gives us a sense of hopelessness - we are not able to help these cats, no matter how hard we try and fight for them.

Moreover, having to give the news to a guardian that his cat will die slowly with a virus that has no cure is one of the hardest moments in clinical practice.

Hence, this blog is dedicated to our fantastic veterinary colleagues who, through their long years of hard work, have finally brought us the wonderful news that we have all been longing to hear:

“Curing Cats with Feline Infectious Peritonitis with an Oral Multi-Component Drug Containing GS-441524”. Este trabalho é da autoria de Krentz, D.; Zenger, K.; Alberer, M.; Felten, S.; Bergmann, M.; Dorsch, R.; Matiasek, K.; Kolberg, L.; Hofmann-Lehmann, R.; Me li, M.L.; et al.

Cats with FIP, not with FCoV, have a 100% mortality rate!

FIP is a common pathology in cats caused by a mutation of the feline coronavirus (FCoV). Until now, virtually all cats with FIP have a 100% mortality rate, in which the cats died within 8 to 9 days after the onset of clinical signs, or at some point are euthanized as moribund cats.

I will quote from the article, so that the veterinary community realizes that an animal carrying FCoV is not an animal with FIP:

“Only a small proportion (7–14% in multi-cat environments) of cats infected with FCoV, which is very common among multicat populations, develops the fatal disease feline infectious peritonitis (FIP), triggered by spontaneous mutation of FCoV, thus gaining tropism for monocytes/macrophages in individual cats. All cats with FIP either die or have to be euthanized without availability of effective treatment. The median survival time of untreated cats is only eight to nine days”. (Krentz et al., 2021)

What about the diagnosis? What is the recommended method(s) to identify FIP-FCoV?

“A diagnosis of FIP was made if (1) virus was detected directly, either by immunohisto-chemistry detecting FCoV antigen within macrophages of altered organs and/or by detection of a mutated strain of FCoV in effusion, blood, or an organ fine needle aspirate by a commercial RT-PCR and analysis targeting FCoV spike gene mutations leading to spike protein substitutions M1058L and S1060A (IDEXX laboratories, Ludwigsburg, Germany) in combination with (2) clinical and clinicopathological abnormalities considered typical for FIP being present in the cats”. (Krentz et al., 2021)

So what was discovered in the study conducted?

In the study by Krentz et al. 2021, a population of 18 cats with FIP was included. Their main objective was to prospectively determine the efficacy and toxicity of the orally administered (SID) drug Xraphcom® in cats with FIP in the laboratory and subsequently in cats.

Xraphcom® is an effective drug with an active component called GS-441524 (active form of the drug Remdesivir) which is recommended for the treatment of FIP and severe pathologies associated with the coronavirus in any species.

At the end of the 84-day treatment period, all 18 cats included in the study had fully recovered, with this study showing a 100% survival rate, in contrast to the 100% mortality rate for this disease. During treatment, levels of viral excretion were observed to decrease within a short period of time from the start of treatment, and no cats showed FCoV RNA-positive after 14 days of treatment.

Side effects of treatment with daily oral administration of GS-441524 are negligible, with the most pronounced adverse effect being lymphocytosis that occurred in 14 cats. The lymphocytosis may be due to the age of the cats, as younger cats have a higher amount of lymphocytes. Another side effect was eosinophilia, and there was no apparent reason for its occurrence. There was no kidney toxicity, which was in line with a previous study. In another study, the efficacy of oral administration of GS-441524 in rats was revealed. The main limitation of this study was the small population and the absence of untreated control groups.

(Krentz et al., 2021)

I advise you to read the full article. Congratulations and best wishes to our colleagues who participated in this study and contributed to this wonderful discovery!

What a great start to the year 2022!

Yours always,

Vetexpertise Team