Luna Goes to Chicago (Her 7th State)
This is my personal recap of the information presented at the Winn Feline Foundation, “Ending FIP, Is There Hope” Symposium. I took my own personal notes as as Dr. Niels Pedersen gave his talk about current FIP research. It was awesome to hear so much of the overwhelming FIP data that we read about, presented in a way that put many of the pieces of the FIP puzzle together for a better understanding. As not only new hybrid cat owners, we had also never heard of FIP. In a matter of just a few weeks of cat ownership, we were hit with words that we ever expected to hear, “your kitten has FIP and only a few weeks to live, let us know when you feel the time has come to put her down”.
Having a medical background only further perpetuates my thirst for knowledge about this disease and how I can help others understand it. When I learned that Dr. Pedersen would be presenting his research just 6 hours away from home, I knew that we had to go! Not only did Luna receive one of these brand-new life-saving trial drugs under his expert guidance, I have developed an interest in learning more about the science behind these evidence-based treatment approaches and helping to encourage donations to fund his work.
As with our recent road trips since this little lady came into our lives, Luna came along with us to Chicago. We took her to the meeting area beforehand so that some of the wonderful people that we have met through this endeavor could meet her (photos above).
The Winn Foundation, specifically the Bria Fund, founded by Susan Gingrich after the loss of her cat, Bria, provides much of the funding for these clinical research trials for which we all are excited, and even a bit impatient about. That leads me to make yet another request to everyone reading this, to please consider giving to the Bria Fund to help keep these trials moving forward. To quote Peter Cohen, founder of www.zenbycat.org, (another means of donating money for FIP research and purchasing products that contribute to ZenByCat) “We not only need the money to find a cure, we now need it to fund the cure”. Please considering setting up a monthly recurring donation of only $10 to one of these funds. I say “only $10” because that is a reasonable amount that just about anyone can afford and if it’s recurring AND if hundreds of people do it…well, I don’t need to tell you how that will add up!
The Winn Feline Foundation has granted over $675,000 over the last 25 years to the FIP research cause. Please take the time to watch this video that was shown at the symposium and created by Peter Cohen, founder of ZenByCat and owner of two UCD trial kitties; one who has so far beaten FIP, Smokey (a cat that was accepted into the program who’s owner could not make the trip to UCD) and Miss Bean, whose disease was sadly too far advanced and did not survive the trial.
Here is my summary and notes from the symposium.
Feline Infectious Peritonitis is the most complex of all feline infectious diseases and the most fatal. Corona is an RNA virus, which are more prone to mutation and there are multiple strains of it. It is similar to the viruses that cause Ebola, Aids, Influenza, and Rhinovirus. Feline Enteric Corona Virus (FECV) is transmitted via fecal/oral mode, by seemingly healthy cats. Cats shed the virus very easily due to their very short intestinal tracts (the shortest of all species). Because cats are only meat-eaters, their digestion is quite simple, hence they have a shorter tract.
The presence of FECV itself is not a diagnosis of huge importance because it is found anywhere that there is an increased number of cats; catteries, shelters and homes with a large number of cats. FECV generally starts around 9 weeks after birth in nursing kittens. The more kittens in any given environment, the more prevalent FECV tends to be.
FIP incidence is climbing and is due in part to bottle-fed rescue kittens, in other words, those weaned too early and thus exposed to mass amounts of pathogens. Another contributor is from pedigreed catteries, leading to a 50% increased risk, due to a lack of genetic diversity. The incidence of FIP is .3% or 3 cats in 1000; 1-5% of cattery and shelter cats.
FIP occurs in older cats because they lose their immunity as they age. In many cases of multiple cat homes, when an older cat dies, the owner often gets a new kitten so the existing [older] cat can have a buddy; which then causes the older cat to get sick from FECV from the kitten.
Clinical signs of FECV are often times unapparent and reinfection is possible. The intestinal villi are attacked by the virus and then the virus settles in the colon causing vomiting, mild diarrhea and loss of appetite in cats that do show symptoms.
Mutant FIPV is not infectious from cat to cat and is comparable to Tuberculosis in humans. The mutation becomes active through a process called “Reverse Transcription”. RNA converts to DNA which converts to Protein; meaning it takes 3 stages for the mutation to occur.
Causes of FIPV mutation include: Early spay/neuter in the 8-10-week age, early weaning, and stress in general. Even the idea of mating a pair of FIP-immune cats will not stop the progression, and in fact, those kittens are at a higher risk due to polygenic factors.
Effusive or wet FIP causes fluid to accumulate in the abdomen or chest wall. This fluid does not need to be removed unless it is causing breathing difficulty (if around the lungs/heart) as it will always come back within a few days. Dry or neurological FIP causes tumor-like lesions (polygranulomas) on the organs that leads to organ failure. Cats with dry FIP can live for months or even years in rare cases since the progression is slower than effusive FIP. While cats progress quickly once diagnosed with wet FIP, the most common cause of death from FIP is euthanasia, as most vets recommend putting the cat down since there are no curative treatments.
Symptoms of FIP include: Cyclic fever that does not respond to antibiotics, increased bilirubin (jaundice), failure to thrive (weight loss), effusion (fluid-retained, swollen abdomen), and anemia. Anemic cats have generally been sick longer than you think.
Diagnosis of FIP is not as complicated as it is made out to be, even though there is no single test to diagnose FIP. Multiple vet visits/opinions are not always needed with effusive FIP, which presents with a light to dark yellow colored abdominal or chest fluid, along with a non-responsive (to antibiotics) fever and failure to thrive. CBC, total serum protein, albumin and globulin (a low A:G ratio) can further confirm suspicions. FIP-infected cats are generally anemic, have elevated leukocytes and neutrophils, increased bilirubin and decreased lymphocytes.
Prevention of FIP can be improved by keeping rescue organizations and catteries small and for breeders to avoid mating cats that have produced kittens known to have died from FIP.
Treatments: Immunostimulant/suppressors have no curative powers, only serve to make the cat feel better, and are extremely expensive. Plant-based compounds or other therapies that claim to prolong the lives of FIP cats have not been properly tested. Vaccines have not been proven effective since most kittens are exposed to FECV before 16 weeks. What has been proven effective and to have curative effects, are anti-viral drugs. For the first time, two drugs have been found to have caused remission, if not a cure.
GC376 is the first drug. This drug was developed by collaborators with Kansas State and Wichita State. The drug belongs to a class known as “Protease Inhibitors” which stops the virus from replicating, allowing the body to heal. It does this by inhibiting protease, which is an enzyme that the virus needs in order to infect more cells.
23 cats were given GC376 with 7 cats having been saved; meaning they continue to show no present signs of disease. 13 cats either relapsed or showed signs of neurological symptoms/brain infections. This is because this drug cannot cross the blood-brain barrier. The blood-brain barrier is the body’s natural defense that keeps viruses from causing coma; however, it is problematic when trying to treat with anti-viral therapies for the dry FIP form. One cat in this trial relapsed a total of four times, resulting in each re-treatment time being longer and ultimately, a 12-week course of the drug allowed the cat to stay in remission.
The newer anti-viral drug, a Nucleoside Inhibitor of Reverse Transcription (NRT), that Luna and a few other cats are taking now, works earlier in the cycle to halt replication by stopping RNA from becoming DNA and is having very good results thus far. I know of at least 4 others cats, who’s owners have reached out to me, that are responding as well as Luna is to the treatment, and 1 that showed signs of the dry form that did not survive despite several weeks of the drug therapy.
These trials can be rather tedious and time-consuming and without guarantees of immediate or sustained remission. The mere fact that there are cats up to one year out shows that the researchers are on the right track to actually finding a cure for FIP.
Why are only a small number of cats used in the trials and why can’t more cats be treated? First of all, these trials do not require a large number; 20 is enough. You just need the right criteria to be met. It is also very expensive to conduct these trials and as always, funding, as well as the drugs themselves are limited. (There was actually a FIP cat owners who tried to “buy their way in to the trial” by offering an exorbitant amount of money!) The criteria for these trials are simple: Ideally, <18 weeks of age, but some cats have been up to one year of age, a confident wet FIP diagnosis, and no signs of neurological symptoms. Once a number of cats have been given the drug, it takes the research team time to evaluate preliminary results, response times, and calculating dosage regimens before findings can be reported and a trial advanced to the next stages.
Our Luna is one of Dr. Pedersen’s success stories on the second drug. She is the first privately owned, naturally-acquired, FIP cat to receive the NRT drug, so all we know is what we see now and that is normal lab values and no visible symptoms of the disease, 9 weeks in. GC376 has 7 of the same and are 9-12 months out. If this isn’t reason to think that this could be the answer, I don’t know what is!
To recap, these drugs are NOT yet commercially available nor are they in production and won’t be for an undefined period of time. Therefore, no matter how much we want/wish for them to be, it’s important to understand that approval and production is FDA and drug company dependent. Rather than complaining that they aren’t yet available, the best approach is to put that energy into raising FIP awareness, education, prevention, and by helping to fund the process to make more trials possible. It is through our donations that grants can be given to research and development teams to continue finding viable treatments. To quote Dr. Pedersen: “Results from studies in our laboratory and elsewhere indicate that we have entered a new era in FIP prevention and treatment”.