How best to manage a previously deadly disease

Feline infectious peritonitis (FIP) is a common infectious disease caused by a coronavirus - similar, but different to COVID 19. It is most common in young cats and historically carried a near 100% mortality rate. Highly effective treatment options have recently been discovered over the past few years, however veterinary access to these medications is limited and there are still many details about treatment protocols that require further research. 


A medication called Remdesivir is currently the only medication available to New Zealand veterinarians for the treatment of FIP. This medication appears to be able to cure around 85% of cats, with a previously fatal disease. Initial research focused on giving this medication as daily injections for 12 weeks as it was unknown if it was absorbed as an oral medication. This is problematic as the injectable solution is expensive (around $10,000 for one course) and often difficult for owners to administer, limiting the number of cats that can be treated. The cost of the oral treatments are around 1/8th that of the injections, and oral treatment will likely have fewer side effects (skin reactions and pain on injection). 


As a result of the problems with injections, there is a desire to move to treatment methods that involve either shorter courses of injectable treatment, followed by oral treatment, or oral treatment for the entire course. A study performed at UC Davis has shown that oral remdesivir can be absorbed in healthy cats. However, cats with FIP may absorb medication differently. A similar study in cats with FIP is required to determine how it is absorbed in cats with FIP, and also evaluate the effectiveness, and optimise treatment protocols with remdesivir to maximise the success of treatment and ensure that treatment is available to as many cats as possible. 


And that's exactly the study Dr Kelsey Renner from the Auckland Referral Centre intends to undertake with the funding provided by Healthy Pets New Zealand. The study will use 20 client owned cats who have been definitely diagnosed as FIP and not previously undergone treatment. One group will be treated with the traditional injectable method for 2 weeks, followed by oral treatment for 10 weeks, while the second group will have oral treatment only right from the start. Owners will be able to choose which treatment group their cat goes into, as there will be a considerable cost difference. The cats will all be treated for 12 weeks, then continue to be followed for the next 3 months where they will be conisdered to be in remission if no abnormalities are detected. 


Thanks to CAV for their continued support of the Research In Practice Grant under which this project has been approved. Cases will be recruited throughout 2023, with preliminary results expected in July 2024. Watch this space!