Goto S, Kamiyoshi T, Iwasaki R. Predictive factors associated with short-term mortality in cats with feline infectious peritonitis treated with remdesivir or GS-441524 or both. J Vet Intern Med. 2025 Jan-Feb;39(1):e17249. doi: 10.1111/jvim.17249. Epub 2024 Nov 27. PMID: 39600237; PMCID: PMC11638120
FIP is a severe and often fatal disease in cats caused by mutated strains of the feline enteric coronavirus (FCoV). While many cats are exposed to FCoV, only a small percentage develop FIP. This occurs when the virus mutates within the cat’s body, leading to a widespread inflammatory response. The mutated form is known as Feline Infectious Peritonitis Virus (FIPV). FCoV is commonly spread through feces, saliva, and shared litter boxes. Stress, genetics, and altered immune function can increase a cat’s risk of developing FIP. Young cats, especially those between 3 months and 2 years old, and purebred cats are more prone to FIP, however rit can affect cats of any age.
While FIP was once considered universally fatal, newer treatments have significantly improved survival rates. Medications like GS-441524 and remdesivir, both antiviral drugs, have shown promise in treating FIP. These medications help to reduce the virus’s ability to replicate. Treatment can be lengthy, often lasting 12 weeks or longer, and may involve injections or oral medications. Other treatments focus on managing the symptoms and supporting the cat’s immune system.
This study examined factors to predict whether cats with Feline Infectious Peritonitis (FIP) will survive with treatment using remdesivir or GS-441524. The study reviewed the medical records of 108 pet cats diagnosed with FIP across multiple veterinary centers.
The authors found that 12% of the cats died within 84 days of starting treatment. Several factors were linked to a higher risk of death, including high levels of Lactate Dehydrogenase (LDH) in the blood; high bilirubin levels, and low levels of albumin, total protein, sodium, and potassium. Of these factors, only high LDH levels (≥323 U/L) were strongly associated with a higher risk of death. The researchers suggest that measuring LDH levels can help veterinarians predict which cats are at higher risk of dying soon after starting treatment. This information can help guide treatment decisions, allow for closer monitoring of higher-risk cats, and provide pet owners with a more accurate understanding of their cat’s prognosis.
Identifying prognostic indicators is crucial for both veterinarians and pet owners. Knowing which cats are less likely to respond favorably to treatment allows for more informed decision-making and management of expectations. LDH is a common blood test included in routine veterinary diagnostic panels, though not often performed in small animal medicine.
While end of life or treatment decisions should never be made based on a single factor, the information in this study may be valuable as part of a comprehensive assessment and treatment plan for cats with FIP. ~MK
See Also:
Pedersen NC, Perron M, Bannasch M, et al. Efficacy and safety of the nucleoside analog GS‐441524 for treatment of cats with naturally occurring feline infectious peritonitis. J Feline Med Surg. 2019;21:271‐281. PMCID: PMC6435921 DOI: 10.1177/1098612X19825701
Dickinson PJ, Bannasch M, Thomasy SM, et al. Antiviral treatment using the adenosine nucleoside analogue GS‐441524 in cats with clinically diagnosed neurological feline infectious peritonitis. J Vet Intern Med. 2020;34:1587‐1593. PMCID: PMC7379040 DOI: 10.1111/jvim.15780
Coggins SJ, Norris JM, Malik R, et al. Outcomes of treatment of cats with feline infectious peritonitis using parenterally administered remdesivir, with or without transition to orally administered GS‐441524. J Vet Intern Med. 2023;37:1772‐1783. PMID: 37439383; PMCID: PMC10473006. DOI: 10.1111/jvim.16803