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FIP Treatment Options

Once a diagnosis of FIP has been made, then a decision regarding appropriate treatment can be made. This sounds simple, but it is rare for the diagnosis to be absolutely certain. Some vets will commence treatment when the diagnosis is assumed or whilst waiting definite test results. Sometimes these ‘definitive’ tests reveal a negative result when cats do have FIP – a false negative. In all cases where treatment is started without a certain diagnosis, consideration must be given to the fact that your cat may NOT have FIP and you need to be prepared to re-evaluate the diagnosis. This may result in involved further testing. Also, after several weeks of treatment you may well realise that perhaps the treatment was not necessary or only appeared to be effective. This brings up worries of possible unnecessary adverse reactions. As coronavirus infection is so common, viral resistance may develop.  Throughout this journey we will be able to accompany you and help you with any questions you may have around the choice of treatment, your cat’s response to treatment and understanding the monitoring of treatment.

Prior to the development of specific antiviral treatments, FIP was almost always fatal. With new antiviral treatments many cats can respond well to treatment despite extensive organ damage. These treatments have been available in the UK for several years, but we still have lots to learn about the true long term response to these treatments and what if any long term health effects there will be on affected cats.

In the UK a widely recommended treatment regime is with Remdesivir or GS-441524 prescribed by your veterinary surgeon.  This may be a course of tablets or started initially with injections and then followed up with tablets. An oral liquid form of treatment is now also available. Legally this treatment is only available through veterinary surgeons but also it is really important that your vet is there to monitor the treatment and advise on any additional treatments which are often helpful. Also the required dosing schedule will depend on a professional evaluation of the clinical signs throughout the duration of treatment. The minimum current recommended treatment time is 84 days ( 12 weeks). Research is ongoing into new protocols.

Dosage recommendations for Remdesivir and GS-441524 

This is a long process which can be a great challenge. The injection can be painful. Giving tablets can also be challenging in some cats. It is important to be aware of this commitment at the beginning. We are here to help you with support and some top tips to make this easier. 

Injectable Remdesivir

  • Cats with effusions and without ocular or neurological signs  – 10 mg/kg once daily
  • No effusion and without ocular or neurological signs  – 12mg/kg once daily
  • Ocular signs present (effusive and non-effusive) – 15mg/kg once daily
  • Neurological signs present (effusive and non-effusive) – 20mg/kg once daily

Oral GS-441524

  • Cats with effusions and without ocular or neurological signs  – 10-12mg/kg once daily
  • No effusion and without ocular or neurological signs  – 10-12mg/kg once daily
  • Ocular signs present (effusive and non-effusive) – 15mg/kg once daily
  • Neurological signs present (effusive and non-effusive) – 10mg/kg given twice daily – a total daily dose of 20mg/kg

Supportive treatments

Many cases will benefit from supportive treatments, all of which are best given under the direction of your veterinary surgeon. Examples of these are as follows. Not every cat will benefit from nor need  all of these treatments.

  • Feeding support by use of special diets or tube feeding
  • Appetite stimulants and anti-sickness treatments
  • Vitamin B12 supplements by injection or orally
  • Immune support such as Polyprenyl immunostimulant after at least 8 weeks of treatment
  • Liver support medication such as Denamarin or Samylin
  • Probiotics

We are here to help explain how these treatments are used and help you understand how to get your cat to recover as well as possibly from this disease.

Monitoring during and after treatment

Once your cat is at home and under treatment, monitoring the progress is vital. Weekly or fortnightly assessments are useful initially. These serve to monitor response to treatment (and whether the diagnosis is correct), whether signs are changing and whether the dosage needs adjusting. Your cat’s weight should be monitored at least once weekly. Dosage must be adjusted according to changes in your cat’s weight. Regular blood tests, ultrasound scans and physical examinations can help to detect progress.

The results of these monitoring assessments can sometimes raise many questions and we are here to help you understand this process and address any concerns you may have. We will liaise with your vet so that they are aware of any issues or questions you haven’t had chance to discuss with them.