Is there a cure for FIP? Can a cat with FIP survive?
Time is of the essence for a cat with FIP. The only proven cure for a cat with FIP is GS441524.
It has a ninety-three percent success rate and comes in injectable and pill form. The preferred one is injectable. If there are any GI symptoms this can affect the absorption of oral meds. All the supportive care can happen at home. And the virus moves too fast to delay.
GS starts to work fast. Within a period of twelve to twenty-four hours after the first dose, the fever will break.
Within a few doses, appetite and energy level are much improved. By day seven to ten, the fluid should reabsorb, but you will know sooner than that if it is working or not. If it turns out not to be FIP, GS will not harm your cat with FIP in any way. It is an anti-viral.
IMPORTANT: Was your kitty diagnosed with FIP? Click Here.
I have had three of my cat with FIP.
As a result, I have come to learn far more about this disease than I had ever hoped to know. I have had not one cat with FIP but three.
I hope I can spread awareness of this fatal virus. I hope the options are available to any cat-parents who face this dreaded diagnosis. I share the story of my cat with FIP here.
Before October nine, 2018, I had never heard of FIP or was aware of any cat with FIP.
Despite having cats for over forty years. It turns out I had a cat with FIP. Not just one but two cats with FIP.
That was the day the diagnosis for my sweet little Lily got done. It showed she had wet FIP and died of it at only twelve and a half weeks old. The diagnosis for her brother Jack would later prove he has dry/neurological FIP.
He passed away two days shy of his eight-month birthday. My baby Jack died on March fifteen, 2019. My cat died the same day the anti-viral known as "GS441", the cure for FIP, became available on the black market. One day too late to save my baby boy.
Having a cat with FIP and not having access to treatment can make you feel helpless.Written by Alicia Hughes
WHAT IS FIP?
If you are not familiar with FIP, it is a virulent virus. It is an acronym for Feline Infectious Peritonitis. It occurs when the otherwise benign Coronavirus mutates. The mutation is either due to an immune deficiency or a genetic predisposition of your feline friend to FIP.
Most cats in the world get exposed to the benign Coronavirus (FCoV).
90-95% will clear the virus with a short bout of:
- Cold-like symptoms
- No symptoms at all.
In 5-10% of those cats, the virus goes thru a sequence of mutations. This sequence tricks the white blood cells into spreading the virus, rather than fighting it.
The benign FCoV is contagious and can spread among cats through feces to the oral route. It is believed that a mother cat can transfer FCoV to her babies via the placenta.
Cats can carry FCoV for days, weeks, or even years, and not develop FIP.
Cats may also be chronic or intermittent shedders of FCoV. They may never display any symptoms or go on to develop FIP.
The vast majority of cats will never suffer the mutation into FIP.
5-10% will progress from FCoV to FIP. Once the mutation has occurred, the virus is not transmissible. It is also not contagious. The cat with FIP will no longer be shedding FCoV in its feces.
The mode of transmission is not known. The current theory is that FIP gets passed through oral or nasal contact with FECV.
FECV means feces infected with feline enteric coronavirus (FECV). It is a common virus that mutates in some cats to become FIP. A mutation is a change in the genetic code of the virus. Transmission may also occur from a queen cat to kittens.
Circumstances that may influence whether FECV mutates to FIP in a cat are:
- Age of cat (most susceptible cats are less than one year old)
- Breed of cat
- General Health
- Immune status
- Environmental stress.
On its own, FECV is not a life-threatening virus, but it can cause diarrhea and is contagious among cats. Every cat will have an antibody titer in some batteries and multi-cat households. This titer indicates exposure to a feline coronavirus.
This coronavirus titer test does not differentiate between FEV and FIP. It is not a reliable screening test. This, in turn, makes assessing protection from vaccination difficult.
The efficacy of the FIP vaccine has been controversial. Some studies show that it offers some protection against the disease. Others fail to prove significant protection.
The AAFP report states that the vaccine is not yet beneficial. As a result, there is no prescription for it. The incidence of cat with FIP in pet households is low.
The AAFP panel could not conclude what makes up an "at-risk" cat. One at-risk category would be cats in households where there has been a diagnosis of a cat with FIP. Vaccination in that situation could protect cats not yet exposed.
The cat gets the vaccine in two doses, 3 to 4 apart in cats over sixteen weeks. Booster doses are available, too.
FIP vaccine is only available in an intranasal form.
A cat with FIP that has no immune response to FCoV, they develop the wet form of FIP.
The wet form in cat with FIP has a vasculitis that allows fluid to build up in the abdomen (ascites). Also, around the lungs (pleural effusion) and/or around the heart (pericardial effusion).
Early symptoms for wet FIP for a cat with FIP include:
- High and persistent fever.
- A pot-bellied appearance that feels like a water balloon (in the case of ascites).
When the pleural effusion is present, a cat with FIP's breathing may sound congested for. Like labored breathing with open-mouthed breathing.
In the case of a pericardial effusion, the cat with FIP may develop an acute heart murmur. Also, an increased heart rate or a clear watery nasal discharge may occur.
Wet FIP is the simplest of all forms to diagnose, although still far from perfect. The cat with FIP's health history gets considered. This includes cats from:
Every place, where cats live in close quarters, is at the high risk.
The most common age for a cat with FIP is under two years, or over eight years. But FIP can strike at any time.
The vast majority of cases, that include a cat with FIP, is in the five to nine-month range. The reason behind that are the several stressors which occur at this age.
Cats and kittens are at a higher risk, if they're:
- Recently adopted
This is because these common stressors disrupt and weaken the immune system. In combination with concurrent exposure to FCoV, they create the perfect storm for a cat with FIP.
Besides the patient history and physical exam, a CBC and Blood chemistry panel are usually run.
With wet FIP, classic markers are present, which include:
- High white blood cells
- High TBIL
- High neutrophils
- High protein
- Low red blood cells (non-regenerative anemia)
- Low albumin
- High globulin.
A fluid sample gets drawn and observed for color and texture or sent out for a PCR. A simple inspection of the fluid from a cat with FIP is enough for a vet to diagnose it.
If the fluid is straw or honey-colored and sticky, it indicates a cat with FIP. Though fluid of a different color or texture does not rule out FIP in a cat with FIP.
If a PCR gets sent out, a positive result is a conclusive diagnosis. But have in mind that a negative result does not rule out cat with FIP, since there is a shocking 30% chance of a false negative.
If the cat has a partial immune response to FCoV, he or she will develop Dry FIP.
This form is much more difficult to detect and diagnose. This is because it does not follow the same pattern from cat to cat. The dry form shows lesions and granulomas on the cat with FIP's organ(s). The virus may end up in any or all organs, depending on how it travels thru the cat's system.
Outward symptoms will also depend on which organ(s) gets affected. The most common early symptoms for a cat with FIP from the dry type could be:
- Low-grade, persistent fever
- Third eyelid protrusion, all are non-specific.
More severe symptoms for cat with FIP from the Dry kind may include:
Vets start the diagnosis process the same, no matter which kind of FIP a cat with FIP has. This involves:
- Evaluating the cat's health history
- Evaluating symptoms
- Chemistry panel.
The classic markers seen in the labs with wet FIP may or may not be present with the dry form.
- Thickening of the GI tract
- Enlarged mesenteric lymph nodes
- Free fluid around kidneys
- Enlarged organs
- Granulomas on organs.
You might send out tissue samples for immuno-staining. But more often than not, this isn't necessary if the classic markers are present.
Immuno-staining can also yield a false negative so it's not a 100% conclusive.
OCULAR AND NEURO FIP
Ocular and/or neurological symptoms can go with both the wet or dry form in a cat with FIP. They show a more advanced stage of the virus. Once the virus crosses the blood/eye barrier or the blood/brain barrier, it progresses fast.
Ocular symptoms include uveitis, keratic precipitates. Aqueous flare or retinal vessel cuffing may also be present.
Neurological symptoms may occur, too. These symptoms appear, if the virus has affected the central nervous system or brain.
- Seizures, or
- Nystagmus (darting eyes).
There are diagnostics available, for example, PCR on the aqueous fluid of the eye or spinal fluid. But these procedures are rather invasive.
Given that they are not a hundred percent accurate or conclusive, most people decline to run these tests.
FIP is still a death sentence, but THERE IS A CURE.
Vets are not allowed by law to prescribe GS441 because it is not FDA approved.
Some are not even aware that it is accessible. Others refer their patients to the FIP Warriors group for finding the medication.
More vets are becoming aware, following an article about the FIP Warriors. The article came out in Veterinary Info News (VIN) in August 2019.
GS441 treatment for a cat with FIP
During the treatment period of FIP, the owners keep track of different variables. This includes:
Clinical signs of the original disease at daily or weekly intervals are also tracked. Diagnosis of blood tests at the onset of treatment and every four weeks thereafter is also performed.
The goal of tracking is to have a healthy, alert and active cat at the end of twelve weeks of treatment. And cat with normal blood test values.
You may also need supportive care to stabilize the health of a cat with FIP.
The care also includes:
- Administering fluids and electrolytes to counteract dehydration.
- Antibiotics when a secondary bacterial infection is present.
- And anti-inflammatories (systemic corticosteroids), and
- Rarely blood transfusion.
Topical medications may also counteract severe inflammation. And increased intraocular pressure (glaucoma) in some of the cats with ocular involvement.
The treatment with the injection form of GS can also complicate injection site sores. The treatment is hard on both owners and cats, as injections can be painful.
There is also a problem in some cats with FIP, especially those where neurological damage is present. This involves the development of partial drug resistance, which requires an increasing dosage.
Response to treatment is within twenty-four to seventy-two hours. Most cats are back to normal or near-normal within two to four weeks, which is a good sign.
The cure rate for FIP with GS-441424 has over 80% success rate.
Treatment fails are most often due to:
- Misdiagnosis of a cat with FIP
- Inadequate dosage.
Complicating disease conditions, and drug resistance also contribute.
Young cats are easier to treat and have a higher cure rate than old cats greater than seven years of age. A cat with FIP, whether it is wet or dry, is easier to cure than with cats, whose condition is not complicated by any neurological or ocular disease.
GS441: The Myths and the Facts
GS441524 is a nucleoside analog that cures FIP in a cats. It acts as an alternative substrate. It is also an RNA-chain terminator of viral RNA-dependent RNA polymerase.
In Layman’s terms, GS441 interjects itself into the chain reaction of the virus. The medication stops it from replicating, and cures the cat of FIP.
So, why isn't this miracle cure available at the vet's office to cure a cat with FIP?
The patent for the GS441524 was available by Gilead Science. It was used in the human Ebola drug, Remdesivir.
In 2017, Dr. Niels Pedersen had access to the molecule for FIP research. The various field studies proved that GS441 cured twenty-five out of twenty-six cats with FIP. Moreover, it cured all forms of FIP, including the toughest forms: the ocular and the neuro FIP.
As of today, the twenty-five cats that survived the field study are alive and thriving, with no recurrence of the virus. But the fact that GS441 could cure a cat with FIP was never the intent of Gilead Science. They don't even have a veterinary division. As such, they never produce this medication for cats.
In September 2019, field studies of Remdesivir for the human Ebolavirus failed. Gilead withdrew its FDA application. They are now researching alternative human applications for the molecule.
Gilead would consider releasing the veterinary use patent to another manufacturer. A manufacturer that has a veterinary division. This patent would create a human anti-viral drug with this molecule and get FDA approval.
This could be years, could be a decade, before it comes to fruition. Meanwhile, thousands of cats are dying, while the cure sits on Gilead's shelf.
The raw chemical compound for this drug is available from several bio-labs.
The instructions for the diluent are in the GS441524 Safety & Efficacy Study. It's not exactly something a regular person could whip up in their kitchen. But it does not need a Ph.D. in Chemistry, either.
It didn't take long after the release of the field study for a several China-based labs and universities to start manufacturing black market versions of GS.
While these drugs are unregulated and non-FDA approved, they are not illegal. They're discussed online, in veterinary publications, at FIP seminars and symposiums, etc.
One of the manufacturers recently participated as a vendor at the NYC Vet Show.
GS is currently available in two forms:
- An injectable drug
- An oral capsule/tablet.
With either form, the treatment protocol involves eighty-four days of daily dosing. This also involves an 84 day observation period.
The daily dose depends on:
- The weight of the cat
- The form of FIP
- The concentration of the medication.
During the initial treatment period, rechecking of the lab occurs at four, eight, and twelve weeks. The same is also done during the observation period.
If there is no relapse during the 84 day observation period, the cat becomes cured.
If there is a relapse, the cat will need to extend treatment further than the initial twelve weeks. The success rate for curing FIP with GS is around 90%.
The cost of treatment ranges from $700 - $10,000, again depending on the cat's:
- Type of FIP
- The brand of GS used.
The vast majority of treatment falls into the $1500-3000 range. For twelve weeks, excluding diagnostics and/or vet exams.
Does Pet Insurance Cover The Expenses of a Cat with FIP?
Pet insurance cannot cover the GS, due to it being non-FDA approved. But the insurers will cover all other FIP-related expenses.
Does GS441524 Treatment Have Any Side Effects When Curing an Infected Cat?
There are no significant side effects with GS.
With the injectable form, the diluent is acidic, so some cats may develop minor sores at the injection sites. The vast majority of them heal on their own without complication or intervention. However, if sores get infected, they might require a course of antibiotics.
With the oral form, the capsules may cause vomiting. This occurs especially early on in the course of treatment.
As far as long-term effects, we can only go back as far as the field studies in 2017. There have been none reported.
A HAPPY ENDING
In the summer of 2019, I was finally ready to adopt again after grieving the loss of my two FIP angels.
My Siberian Forest Cat Petey came home on May twenty-fifth and was the picture of health and perfection. A month later, I fell in love with and adopted a DLH rescue kitten. He had been hand-raised by a vet-tech after they abandoned his litter.
The two boys bonded immediately and were inseparable.
Everything was great until they went to the vet on July twenty-third for a wellness exam and each got their FELV vaccine.
Two weeks later, on August sixth, Petey missed a meal that was completely unlike him. He was five and a half months old at the time and would eat his body weight in food if I'd let him. He went to the vet that afternoon, fearing the worst, but my vet assured me that I was having FIP Paranoia.
His fever was one hundred and four degrees Fahrenheit and his CBC and Chem panel looked normal, except for high WBC and neutrophils. His diagnosis showed a bacterial infection, given a Convenia injection, and sent home. Whew, it was nothing! But no, that would change soon enough.
The next morning, his fever was one hundred and six and a half, he again refused food and water, and he was lethargic. I admitted him into the hospital and for the following four days, he got worse.
Despite three antibiotics, IV fluids, nutritional support, and cooling pads, he still got worse. This happened to the point where he was lying face down in his litter box and he was not expected to survive the week.
On Aug eleventh, the dreaded phone call came. Petey had palpable fluid in his abdomen. They run a new CBC and chem panel. They also sent out abdominal fluid for a PCR. All the classic markers were present and the diagnosis showed he had wet FIP.
After Lily and Jack died, I'd stayed involved with FIP Warriors. This is because I found it cathartic to help other cats beat this monster. I never imagined I'd be needing the support of the group firsthand again.
Due to my involvement, I knew that experimental GS from China was available. I told my vet that Petey was going to try black market GS. That I understood if she could not get involved with his treatment, but her response shocked me.
"If there's anything we can do to save him, I'm not going to let this baby die. How soon can you be back with some GS?"
I found some located about two hours from home, jumped in my car, and drove to NY that night to get it.
He got his first dose the next day.
Within twelve hours, his fever broke and his temp was normal again at one hundred and two.
After the third dose, he ate the full plate of food left for him during the night. The following morning he was crying for more when the hospital staff arrived.
After his fifth dose, he looked and acted like a healthy kitten and he got discharged home. Here he continued to do well. We continued to go to his vet every day to check his weight, temp, and administer his injection.
Petey's entire team was one hundred and ten percent supportive and thrilled with his miraculous progress.
On day twenty-five of treatment, his CBC and chem panel showed tremendous improvement. But he still had some liver and kidney values that were irregular. We stayed the course with his daily injections.
On day sixty-five of treatment, he had a new CBC, chem panel, and ultrasound. The results of all diagnostics were flawless, with no trace of FIP whatsoever!
We consulted with Dr. Niels Pedersen. After which we decided that Petey gets neutered during his GS treatment. He had matured right around the mid-point of treatment. He was becoming aggressive and dominant.
He got neutered on day seventy-two and continued his injections for the remaining twelve days. The theory was that the GS protects his immune system as he recovers from surgery.
He finished his treatment on November third and I'm happy to say that he is FIP-free!
Today he is a healthy, crazy, eight-and-a-half-month-old kitten. A kitten with boundless energy, a voracious appetite, and an endless desire for belly rubs.
The eighty-four-day journey wasn't easy... but giving my baby boy the chance at a long healthy life was worth it!
UPDATE January 26, 2020 – "Today is day eighty-four of the post-treatment observation period. Petey is CURED of FIP!" He's no longer a cat with FIP.
If your kitten has been diagnosed with FIP, you might find support and solutions on these links, too:
- FIP Warriors (Facebook) - Assists with the diagnosis of a cat with FIP. With treatment options, including GS
- zenbycat.org - The founder is the dad to one of the original survivors in Dr. P's first study with GC376. Zen By Cat is a non-profit that raises money for FIP research. They offer cure through donations and affiliate sales of cat-related merchandise.
- fiptreatment.com - My website. It includes current news about GS and FIP. Also includes treatment options, supportive care advice for FIP cats, etc.
- sockfip.org - Dr. Pedersen's website that chronicles his over fifty years of FIP research
- Webinar. Pursuing FIP and WINNing
- WINN FIP SYMPOSIUM PURRsuing FIP and WINNing PDF November 2019
- 2022 Feline Infectious Peritonitis (FIP) Diagnosis Guidelines
Clinical Signs in a Cat with FIP
There are some signs to look out for if you have a cat with FIP. These signs can include:
- Failure to gain weight or weight loss
- Poor appetite
- Fluid buildup in the abdominal or chest cavities
- Neurological disorders.
How Long Can a Cat With FIP live?
A cat with FIP has a waxing-to-waning illness. This means they have good days and bad days. As a result, you may not be able to tell how sick the cat is. The progression of signs is slow, and cats with FIP can have an undiagnosed illness for months.
A kitten can get exposed to FECV by his mother, start and then develop full-blown FIP as late as two years of age. The viral mutation of FIP in a cat with FIP usually occurs in only a small percentage of a cat with FIP.
In a litter of four kittens, one could become infected and die and the others could grow up normal and healthy.
Diagnosing your cat with FIP
Diagnosing FIP is like putting together a puzzle. The only test that conclusively diagnoses the disease is a tissue biopsy. Performing exploratory surgery to obtain a biopsy is not what most owners with a gravely sick cat with a poor prognosis to live want to do.
Instead, the presumption of the diagnosis is based on other tests. Other typical clinical signs also contribute.
The tests performed to diagnose a cat with FIP are:
- Complete blood count
- Blood chemistries
- Coronavirus titer (FECV titer)
- Seven B ELISA for FIP (an antibody titer to a specific viral protein. A positive result supports a diagnosis of FIP, but the test is not definitive)
- Fluid analysis
- FIP PCR - This test uses polymerase chain reaction technology to look for specific proteins. The test is on blood, but it is most useful on body fluids
A presumption of your cat with FIP could be from:
- A lack of response to supportive therapy.
- Not being able to pinpoint any other disease.
- Suspicious test results.
In multi-cat households, it is not necessary to isolate the cat with FIP. This is because all the cats would have the same coronavirus exposure, and odds are that no one else will get sick.
Decreasing the Risks Associated with FIP
FIP is common in purebred cats who come from catteries, and in cats who have come from shelters. This is because exposure to FECV is higher in environments with many cats. Larger multi-cat facilities have more environmental stress. And less ability to isolate sick cats.
Purebred cats may also be more at risk due to genetics and weaker immune systems. The more related cats are, the fewer different genes there are to make their systems stronger.
If a purebred cat breeder tells you he has never had a case of FIP in his cattery, don't believe him. FIP might have occurred at one time or another. The odds are likely if a breeder has been in business for a few years and has bred many litters.
To Try to Decrease the Risk of FIP, Take These Steps:
- If you go to a cattery or shelter, pick a big, healthy-looking kitten and have him examined by a veterinarian.
- Isolate the new kitten from other cats for at least a week to observe his health.
- Allow the kitten to adjust to his new environment. Then perform any elective medical procedures.
- Decrease environmental stress on the animal.
- Keep litter boxes and food bowls clean.
- Feed the kitten a good quality diet and be sure he is eating.
Even if you follow these suggestions, there is no guarantee you will prevent FIP. FIP occurs in only a small percentage of the cat population, but it is devastating if it affects your cat.
FIP and Cat's Age
Age is one of the factors that affects a cat’s susceptibility to FIP. There is a close relationship between age and FIP incidence in a cat.
- 29% of FIP cases occur in kittens under six months of age.
- 50% under ten years.
- 80% less than three years and ninety-six percent in cases below eight years of age.
- The incidence is between seven and eleven years of age.
At least two studies confirm a real but less dramatic increase in incidence (to 3%) in aged cats. One from the USA in 1976 and a second from Europe in 2021.
Several unique situations are associated with FIP exposure. The first scenario occurs in younger cats, i.e., exposure to multiple younger cats.
But, it is a fairly common scenario for families to pair aged cats with kittens and live their lives together in relative isolation.
This leads to another interesting scenario where one cat of the pair is likely to die before the other, leaving it without a companion. A new companion, most often a kitten, is then obtained from a rescue organization.
The chances of a kitten from these sources shedding FECV are high. The second source of FECV exposure also exists that does not need cat-to-cat contact. FECV gets carried on people’s clothes from one cat to another.
FECV is present in high concentrations in litter dust with young cats and kittens. It can survive for long periods in the environment. This means that if the owner contacts younger cats outside of the household, it is possible to increase the chance of FECV infection.
Immunodeficiency of an Aging Cat with FIP
The immune system is susceptible to the negative effects of aging in all animal species. This includes cats.
The decline of the immune functions in aging cats is associated with certain changes. These changes are mostly in the B and T-cell lymphocyte populations, and increased levels of non-specific immunoglobulin.
Thus, old cats often have higher than expected levels of serum protein and globulin. An increase in total serum protein and globulin levels in younger cats is often viewed as a sign of FIP. Whereas their diagnostic value in older cats is less significant.
Pregnant Cat with FIP
Pregnancy has depleting effects on a cat’s immune system. A major effect is on T-cell immunity.
T-cell immunity contributes to identifying infected host cells. T-cell immunity also plays an important role in controlling autoimmune diseases (diseases in which the body’s immune system attacks healthy cells).
The immune modulation that occurs during pregnancy can have variable effects. These affect the mother’s immune system strength.
Pregnancy improves and worsens autoimmune diseases.
It also raises the post-partum risk of autoimmune diseases. There is increased susceptibility to many common:
- Viral diseases.
The incidence of these diseases is greatest in the third trimester. This is when blood levels of estradiol and progesterone are highest.
Cat mothers may be more susceptible to certain infections during pregnancy, including FIP.
Even in case the cat mom gets sick, the fetus remains protected from maternal infections.
Filling the Loss of Your Late Cat with FIP
If you have had the sad and tragic experience of losing a cat to FIP, you may wonder when and if you should get a new cat. There is no definitive answer to this question.
Research shows that FIP can live in the environment for months. But in reality, if you throw away disposable objects and wash everything with a solution of one part bleach to ten parts water, the risk of transmission is slim to none.
The best new animal is an unrelated kitten or cat who is at least sixteen weeks old and appears hearty and healthy. But unfortunately, even this doesn't guarantee that you're not getting a cat with FIP.
If Your Kitty Has Been Diagnosed with FIP:
I am so sorry to hear that your kitty might have FIP.
But, there is hope for a cat with FIP.
Time is of the essence with these kitties. GS441524 is the only proven cure for FIP. It comes in injectable and pill form. The preferred one is injectable if there are no GI symptoms as these can affect the absorption of oral meds.
There are several brands available. Some of which are less expensive but effective as the highest-priced brands. There are also several ineffective brands on the market.
The FIP Warriors admins can help you navigate which brands are trustworthy. Which brands have a proven track record. Storage of meds is everywhere, so cats can get started immediately and don't have to wait for shipping.
And please join this Facebook group. If that link no longer works, please tell me - a new link will be on this page under "FIP Care & Support Groups".
Once your request gets approved in the group, post and asks the admins for help.
When you post please include the answers to the following questions:
- What type of symptoms is your kitty experiencing?
- How old is your kitty?
- Have you run a CBC and chem panel? - Post the results, if you have.
FIP Warriors are not in any way affiliated with any producers and are brand-neutral. The success rate with GS is ninety-three percent but it's imperative to start treatment ASAP.