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How to treat one cat diagnosed with FIP?

And optional subtext

Introduction: FIP is ultimately caused by a feline enteric coronavirus (FECV). In about 10% of cats, mainly kittens, the virus will undergo specific mutations that allow it to escape the cells lining the lower intestine and infect the most basic cell of the immune system, the macrophage. This mutant virus is known as feline infectious peritonitis virus (FIPV) and is initially contained to local lymphatic tissues associated with the lower intestine. FIPV-infected macrophages can then spread the infection to other sites within the abdominal and chest cavities and to distant organs such as the eyes and brain. 
FIP is a serious and acutely disease that can affect a cat's internal organs quickly, including the liver, spleen, and abdominal cavity, there are four forms of FIP: Wet, Dry, Ocular, Neuro. Wet FIP is characterized by the accumulation of fluid in the abdomen or chest, while dry FIP is characterized by the formation of granulomas (lumps of cells) in various organs. Ocular is characterized of uveitis, iritis shown in eyes. Neuro FIP is characterized of weakness shown on leg strength, uncoordinated limbs, and even paralysis.

Medicine Choose: GS

The most effective and perfect treatment for FIP is the antiviral drug GS-441524 for now, although there are several different medicines had been confirmed and work for FIP cats. GS works almost 100% efficiently and causes extremely less toxic in kidney( only 1-2 cats of 100 cats not respond to GS), while other medicines either not efficiently or causes high toxic for kidney organs. For example, GC-376 is gentle in toxic factor, but the ability to penetrate the blood-brain barrier is only 25% of that of GS-441. Although Molnupiravir doesn’t show low barrier penetrate ability, but it causes several times the toxicity of GS, after 84 days treatment, it’s a big burden for cat kidney health, the damage to some cats will be irreversible.

DETERMINING DOSE OF GS

Cat’s daily GS injection or oral dose will be determined by the cat’s symptoms and weight.

FIP WARRRIORS and FIP Global DOSAGE PROTOCOL*

  • 6 mg/kg – 8 mg/kg - Wet FIP with abdominal effusion, pleural effusion.
  • 6 mg/kg – 8 mg/kg - Dry FIP with no ocular or neurological involvement.
  • 8-10 mg/kg - Ocular FIP with uveitis, iritis, uneven pupil in eye.
  • 10-12 mg/kg - Neurological FIP with weak leg, uncoordinated limbs, paralysis.
  • 5mg/kg MORE than original dosage - For RELAPSES.

It is necessary to adjust the dosage appropriately according to the specific situation. When the condition worsens or weight gain occurs, the dosage needs to be increased. When all lat datas are already normal or approaching normal, the dosage cannot be reduced arbitrarily.

Medicine Choose: GS

The most effective and perfect treatment for FIP is the antiviral drug GS-441524 for now, although there are several different medicines had been confirmed and work for FIP cats. GS works almost 100% efficiently and causes extremely less toxic in kidney( only 1-2 cats of 100 cats not respond to GS), while other medicines either not efficiently or causes high toxic for kidney organs. For example, GC-376 is gentle in toxic factor, but the ability to penetrate the blood-brain barrier is only 25% of that of GS-441. Although Molnupiravir doesn’t show low barrier penetrate ability, but it causes several times the toxicity of GS, after 84 days treatment, it’s a big burden for cat kidney health, the damage to some cats will be irreversible.

DETERMINING DOSE OF GS

Cat’s daily GS injection or oral dose will be determined by the cat’s symptoms and weight.

FIP WARRRIORS and FIP Global DOSAGE PROTOCOL*

  • 6 mg/kg – 8 mg/kg - Wet FIP with abdominal effusion, pleural effusion.
  • 6 mg/kg – 8 mg/kg - Dry FIP with no ocular or neurological involvement.
  • 8-10 mg/kg - Ocular FIP with uveitis, iritis, uneven pupil in eye.
  • 10-12 mg/kg - Neurological FIP with weak leg, uncoordinated limbs, paralysis.
  • 5mg/kg MORE than original dosage - For RELAPSES.

It is necessary to adjust the dosage appropriately according to the specific situation. When the condition worsens or weight gain occurs, the dosage needs to be increased. When all lat datas are already normal or approaching normal, the dosage cannot be reduced arbitrarily.

The injections are given sub-cutaneously or “sub-cu” which means just under the skin.

  • Injections are typically given every 24 hours at the same time of day for 84 days.
  • Missing one dose is not serious, because effective blood levels are sustained over 24 h. However, missing a dose is something that should be avoided if at all possible.
  • The needle should NOT poke into the muscle of the cat. Many vets will demonstrate how to do the shots.
  • LEAKAGE - if some of the GS leaks out of the injection site, the rule of thumb is to reinject the amount you think leaked out. If you are unsure, reinject 1/2 of the original dose. Wash the area of the leak with mild soap - such as Dawn dishsoap and warm water. Rinse completely.
  • This video shows Dr. Pedersen demonstrating how to inject GS: https://www.youtube.com/watch?v=okZ4V3JbCgo&t=35s

ADMINISTERING ORAL TABLETS

*Choose tablets and do not use capsules, Capsules are prone to recurrence and have multiple side effects , due to their weak absorption function.

The oral administer requires fast food for 30 minutes before or after giving oral tablets.

  • Oral Tablet are typically given every 24 hours at the same time of day for 84 days.
  • Missing one dose is not serious, because effective blood levels are sustained over 24 h. However, missing a dose is something that should be avoided if at all possible.
  • Do not give oral to cats when they vomit or have poor gastrointestinal.
  • VOMIT OR SPIT OUT-If some tablets are vomited within 4 hours of administration, it is necessary to re administer the medication, measure the amount vomited, and correspondingly give cat the same amount of GS medication.

SUPPORTIVE CARE


BELLY FLUID

DO NOT HAVE IT DRAINED without discussing with vet & admins.

  • Draining the abdominal fluid is very risky and can cause your cat to go into shock and pass away.
  • If fluid must be drained it should be no more than 30% and only if your cat’s belly becomes so full that eating, bowel movements or breathing are affected.

CHEST FLUID

Can ABSOLUTELY and MUST be drained if kitty’s breathing is labored. This fluid can be drained completely

FEEDING

If your cat is not eating, he/she needs to be syringe fed to protect the liver.

HOSPITALIZATION

Your cat may need to be hospitalized for supportive care such as blood transfusions, subcutaneous fluids or oxygen.

PREDNISOLONE OR DEXAMETHASONE SP

MANY but not ALL cats will benefit from a course of short-acting steroids. • Please ask your vet for a prescription.

  • This helps stabilize the kitty while the GS starts working.
  • Once stable they need to be weaned off the prednisolone.
  • The goal is to be off the steroids by week three.
  • 2 mg/kg of Prednisolone for the first few days or a week, then drop down to 1 mg/kg and wean.
  • Don’t go over 1 mg/kg twice per day of Prednisolone, that is anti-inflammatory dosing.

INITIAL DOSING

  • If your kitty isn’t stable or begins to decline, your vet & admins may recommend that you dose twice daily.
  • That means a full dose every 12 hours. Once kitty is stable, you will stretch out to 24-hour dosing.

WEIGHING AND ADJUSTING DOSE

  • Please purchase an inexpensive digital baby scale to weigh with - see SUPPLIES section for links to buy.
  • UNDER-DOSING increases the risk of relapse and resistance.
  • Weigh your kitty in kilograms.
  • If not, MAKE SURE YOU KNOW THE DIFFERENCE BETWEEN 3 lbs 2 oz and 3.2 lbs.

BLOODWORK

  • CBC and full chem panel should be done every 4 weeks during treatment so that your admins can monitor your kitty’s progess.
  • Final bloodwork should be scheduled around day 80 so that your admins can give you the green light to enter observation after day 84.

DON’T MISS ANY INJECTIONS

  • Injections should be at within one hour the same time every day. You can always inject EARLY but ask your admin for help if you need to move the time more than one hour later. • Leaks and misses happen. If you think only some leaked, redo half the dose. If you think most of the dose leaked out, redo the entire dose.
  • Make sure to clean the area thoroughly if the meds leak. Diluted dish soap works well.

COMMUNICATE WITH YOUR VET & ADMIN

  • Let your vet and admins know about ANY negative changes with your kitty.
  • Consult your vet and admin before making any changes to the treatment plan, and do not give any new medications without asking first.
  • PLAN AHEAD - Don’t run too low on GS before ordering more as there can always be shipping delays.