Bioavailability GS-441524

The original article collected from various pieces of information.

In this short post, I would like to focus on the bioavailability of GS441524 when taken orally.

Many of you are probably wondering why GS441524 exists primarily as a solution for injection, or why tablets are so expensive. The fundamental problem is that GS441524 (but also Remdesvir) falls into BCS class IV (low permeability, low solubility), which indicates a substance with poor bioavailability. BCS stands for Biopharmaceutics Classification System, which is a system used to classify drugs according to their solubility and permeability. Bioavailability means the proportion of an administered dose of unchanged substance that enters the systemic circulation. This is one of the main pharmacokinetic properties of drugs. By definition, the bioavailability of a drug administered intravenously is 100%. Bioavailability is lower with any other route of administration. That is why pharmacokinetics play one of the main roles in a clinical study of a new drug, which, among other things, aims to determine the dosage for a given form of drug administration (eg intravenous - subcutaneous - oral). When orally administered pure GS441524, the bioavailability appears to be only about 10%. For this reason, the possible administration of the solution for injection by oral route would probably not bring the desired effect (but maybe someone will try it, I'm just not sure if the life of their own cat is building on it). GS441524 shows very poor penetration into the gastrointestinal tract and a very strong first-pass effect. The first-pass effect is a phenomenon in drug metabolism, where the drug concentration is significantly reduced before the drug enters the systemic circulation (and we are in bioavailability). It is a part of the substance that is metabolised during the absorption process, which is associated with the liver (liver) and the intestinal wall.

And how is this problem solved in tablets? In order for the oral form of any drug to be created at all (and this is also the primary goal of all drug manufacturers), it is necessary to ensure, resp. increase its bioavailability. To a limited extent, this can be achieved with certain additives, but in some cases it is not possible at all. Therefore, some drugs exist only in injectable form, while others have both tablet and injectable form. One of the substances that can increase the bioavailability of the drug is microcrystalline cellulose. In the case of GS441524, it can theoretically increase its bioavailability from 10 to 50%. Ultimately, however, this means that in order to achieve a similar therapeutic effect as when injecting (ie a similar concentration of the active substance in the blood plasma), it is necessary to double the absolute amount of the active substance in the tablet. This is one of the reasons why the content of GS441524 in tablets is stated as the equivalent of GS441524, but it does not reflect its actual amount, which can be, for example, double (I do not know the exact numbers).

Another way to solve the problem is to modify the active substance molecule in such a way as to increase its bioavailability and that its metabolism after oral administration results in the active substance itself.

Due to the fact that the manufacturers of oral forms GS441524 keep secret the specific technological process of production and the exact composition of the tablets, I have no information on how they achieved the result. For example, Mutian states that it uses an active substance in Mutian Xraphconn capsules to treat FIP, which it claims is not GS441524 (which also allows it to circumvent patent rights). By the way, INONOTUS OBLIQUUS FRUITING BODY (wood-destroying fungus, also known as Chaga) is mentioned as the active substance, which is obvious nonsense, because I do not know that this fungus would treat FIP. 🙂

Either way, making a tablet that actually works is clearly not a trivial matter. And this may be one of the reasons why tablets are significantly more expensive than injectable solutions.

Sources:

Read “Bioavailability GS-441524”

Feline coronavirus causing FIP is a treacherous plot of antibodies

You can find the original article at veterinarni-lekari.cz
19. 8. 2020


It is typical for a coronavirus that the particular form of the disease it causes depends on the circumstances. He can be compared to a paratrooper who associates with local guerrillas in the body and, in cooperation with them, undertakes destructive sabotage. However, the virus causing infectious feline peritonitis (FIP) is proof that antibodies from an infected animal can also be used to harm.

Has the cheetah coronavirus decimated?

FIP, with its dry and wet forms, is the best known coronavirus disease in animals (Wolf and Gresemer, 1966). However, more than 20 coronavirus strains are known in cats (Knotek, Freedom, 1996).

All felines are susceptible to coronaviruses. But cheetahs are probably the most sensitive. 10,000 years ago, coronavirus FIPs are thought to have decimated the cheetah population to such an extent that cheetahs are genetically significantly less variable than other felines (Knotek, 1996).

Ability to mutate in the gut of cats

In addition to classic FIP, there are agents of enteral coronavirus infection (FECoV - feline enteric coronavirus) and coronavirus-like particles (CoVLP - coronavirus-like particles). The individual strains cross-immunologically react with each other, but differ in both virulence and mortality. Mortality ranges from 0 to 100 %. An interesting feature is their variability and probable mutation ability in the intestines of cats that have undergone viral enteritis.

Up to 7 weeks

The coronavirus enters the cat's body by the nasal or oral route, even indirectly. All you need for the infection is a shared bowl, a transport box or bringing it into your home on your shoes. The feline coronavirus normally stays in the environment for up to 7 weeks.

After entering the mucosa of the upper respiratory tract or the oral cavity, the virus replicates in the epithelium of the tonsils and small intestine. Secondary infection occurs in enterocytes, but also in other visceral organs (liver, spleen, kidneys and lymph nodes). Antibodies appear 7. − 10. the day after infection, but excretion of the virus by oronasal secretion occurs on day 2 after infection.

Macrophages as a means of transport

However, antibodies do not protect against FIP, vice versa they form complexes with the virus, allowing the virus to enter cells, including macrophages. Damaged macrophages then spread the virus around the body. This condition is exacerbated by stress, immunosuppressive factors (corticoids?) And especially by concomitant feline infectious leukosis (FeLV).

The incubation period depends on many factors, especially the active cell-mediated immune response and its ability to remove infected macrophages from the bloodstream.

Influence of interferon suppression on disease development

Macrophages are involved in the formation of perivascular lesions and the release of inflammatory mediators during the course of the disease. Vascular endothelial damage, blood clotting disorders, thrombocytopenia and excessive vascular permeability occur. Due to the action of prostaglandin E2 (PGE2) from damaged macrophages and neutrophils occurs interferon suppressionwhich normally prevents the virus from multiplying. Under these conditions, however, the virus uses the macrophages of the infected organism for its replication and transport throughout the body. The most massive manifestations of the virus take place in organs that contain large numbers of macrophages - in the liver, spleen, lymph nodes (Knotek, Freedom, 1996).

The effect of interferon suppression on disease development corresponds to my experience with the control of (not only) coronavirus diseases impulse therapywhose principle is stimulation of interferon by the body itself, ie endogenous. This method is both cheaper than the administration of exogenous interferon does not cause the side effects typical of exogenous interferon.

The clinical picture of FIP depends on the form of the disease

Clinical manifestations of 2 main forms of FIP - exudative and non-fusible (ie dry) - is different. In the first case (wet form), fibrin exudate is present on the peritoneum and there is a massive thickening of the mesentery with a watery or gelatinous consistency. The omentum forms a contracted formation in the cranial part of the abdomen. Similar fibrinous effusions may also occur in the thoracic cavity and pericardium, corresponding to the pattern of the disease in humans.

In the dry form, inflammatory diseases of the liver, spleen, lungs, CNS and eyes occur. Hyperbilirubinemia and jaundice may occur in the terminal stages.

Beware of seemingly cured carriers

Incubation time depends on the strain of FIP, the type and massiveness of exposure, the health status and age of the patient and his immunocompetence, especially mediated cellular immunity. It can move from 3-6 weeks to 6 months. A seemingly cured patient can be a hidden vector of the disease.

An intranasal vaccine was used to vaccinate cats, which stimulated the production of local mucosal immunity. However, it is no longer available in the Czech Republic and possibly in the European Union.

MVDr. Zdeněk Cvrček
Veterinary clinic and clinic Liberec

Literature by the author. Read "Feline coronavirus causing FIP forms a treacherous plot of antibodies"

Veterinarians feel "offended"

Written by MVDr. Martin Grym on 22.5.2020 in VetInfo

Veterinarians feel "offended"

Veterinarians have been dealing with coronaviruses in animals for decades. As well as human medicine, which is well aware of coronavirus and coronavirus epidemics (MERS, SARS), there are also specific animal coronaviruses. Dogs, cats, calves, pigs, poultry, ferrets, minks - all these social and farm animals have "their" coronavirus.

Veterinary science has made many advances in recent years. Vaccines are available against some animal coronaviruses, and even in cats, a substance almost identical to the human antiviral drug remdesivir has been tested very successfully.

It is no wonder, then, that veterinarians who have been researching the treatment of animal coronavirus for years would like to contribute their knowledge and experience right now that the world is looking for an effective cure for covid-19. The first experience with a drug very similar to remdesivir was published in veterinary medicine in 2018 and 2019. The treatment was successfully tested on thousands of cats with coronavirus, so-called infectious peritonitis (FIP).

Dr. Pedersen, a cat specialist at the University of Davis, California, who has long been involved in cat coronavirus and its treatment, is disappointed by the human industry's lack of interest in veterinarians' unique experience in treating coronavirus. The drug, which has been tested in cats, is almost identical to the substance remdesivir from Gilead, which holds licensing rights to this substance. This drug is currently being clinically tested in the US, China and other countries. Although veterinarians have previously tried to motivate Gilead to commercially test a FIP-certified substance, the company perceived the registration of this drug for animals unfavorably and in conflict with the registration of the same drug in humans, as the same registration of the same drug against the same disease could the impression that the medicine for cats will be used in humans. China, where the problem with FIP cats has long been very topical, has solved the problem in its own way: it has started supplying the untested substance to the black market, which has not passed the official approval procedure.

Covid-19 can thus bring one positive moment to veterinarians and breeders alike: if remdesivir is tested in humans and properly registered, the drug may become available in veterinary practices for the treatment of FIP in cats over time. Due to the controversial effect of vaccination and the always fatal course of FIP, an effective drug would be useful. Read Veterinarians feel 'offended'

About FIP and its treatment from Bella's blog

Original article on facebook blog Bella doesn't want FIP; 16.1.2020; at FIP Warriors 17.1.2021
Published at FIP Warriors CZ / SK on the occasion of the first anniversary…

© 2020, Jana Zárubová

With today's article I will deviate a little from the daily news about Bellč from your second mother… Many of you have been asking from the beginning how we treat, what we treat, what the drug is called and so on and so forth… Since we have been tense like kshandas since October they asked, believe it or not, but hundreds of people wrote to me, asked for help, and I tried to get medicine for myself and them, was and still am in contact with a lot of foreign veterinarians, we are still trying to help others and other people to get medicine, translate conversations between people and veterinarians to make a faster and better agreement, believe me, we barely had time to eat, so there wasn't even time to write an article about medicine, treatment, etc.…

Well, as Bellča's treatment is coming to an end, I have found time to make my quarter-year effort to study as much as possible among you.
In short, they start with what FIP, or infectious feline peritonitis you want, is… Fipka is a viral disease of cats that cause coronaviruses.
Coronavirus is the common name for the four genera of these viruses, alpha, beta, gamma and delta.

Almost every cat has coronavirus, as it is transmitted fecally orally, it is very difficult to avoid it, in shelters, or if you bring a cat from somewhere on the street. Therefore, very little is needed for a cat to become infected with coronavirus, for example, a simple visit to a cat toilet. The virus should destroy ordinary savo, chirox, but if you do not intend to sit at home in front of the cat and disinfect it every time one of your cats visits the toilet, it is practically impossible to avoid it…

However, the fact that a cat is positive for coronavirus does not mean that it has a fox.
If anyone has questions about this picture, I would like to explain in the comments, but I think that even for those of you who are not English speakers, it will be clear enough. (Note: image translated)

A little more theory about fipa itself. FIP is divided into DRY (non-fusive, dry form) and WET (effusive, wet form) form. Dry FIP is further divided into:

  • Dry form without ocular and neurological symptoms
  • Dry form of ocular symptoms
  • Dry form of neuro symptoms
  • Dry form of neuro ocular symptoms

Please note that normally any Fipka is and will be a deadly disease, this treatment is a chance that it will change, but 100% is not a cure! Don't think, as some have even written to me, that you can live with fip for weeks, months, years… The wet form has an average survival of about 14 days to a month in very exceptional cases, the dry form is slower, but the kitten does not survive for more than a few months. It can't be treated with anything else, so the grandmothers of the spice jar who tried to tell us how they cured it with saffron and basil, really NO… I'm quite an alternative person who doesn't even take ibalgin, but nothing really works for this disease except GS… Let's trust American scientists once 😉 😉
The only chance to defend against the fip and try to prevent it is to keep the cat healthy, support immunity (DO NOT SUPPORT the diagnosis of fip and subsequent treatment of Immunity! It would worsen the effect of the drug) and support its mental well-being, as immune and trampled cat…

Wet fip symptoms and diagnosis - large abdomen due to effusion in the abdominal cavity, it is usually the first thing the doctor examines, does a sono of the abdomen where he sees the wrinkled peritoneum and fluid. I recommend having the fluid removed with a puncture needle and sent to a diagnostic that will tell you with certainty whether it is a fip or not. coronavirus, which can happen in cats that will never have a fip. When taking fluid from the abdomen, the veterinarian usually sees whether it is a fip or not, because the effusion in the fip is yellow. Otherwise, the cat develops greater drowsiness, apathy, the cat eats less and less as the belly grows more and more. Furthermore, you can tell by the overall appearance of the cat, they are so disheveled, they have an elongated face, they just have such a sick dying look, but maybe I can only see it, because we already have a lot of experience with fip cats. Another symptom is a fever that does not respond to treatment.

Dry fip symptoms and diagnosis - in the dry form of fip without obvious neuro or ocular symptoms, the diagnosis is very difficult. Weight loss is the first, the cat is often anemic, for this reason it has pale mucous membranes (gums but also ears) and, as with the wet form, fever. Ocular symptoms are often added, the cat's eyes begin to water, it has narrowed, the pupils are each differently large and react differently to light, the eyes are as if foggy, gray, lifeless. Neuro symptoms include poor walking, over time the cat loses control of the limbs, sphincters. The diagnosis is made by magnetic resonance imaging, the diagnosis is not very clear from the blood, as these symptoms may have a different origin, or unfortunately only when autopsy from pieces of tissue.

But you can easily find all this information on Google… What is harder to find is a cure. At the very beginning, I will refer you to the FIP warriors group, which is an international group of people who are able and willing to find a cure, give you contacts, explain everything and advise you. Unfortunately, only in English, but it is not a problem to invite a Czech member who is willing to help with the translation, I have translated several times myself.

Many of you claim that there is no cure. Basically, you are right, there is no officially approved, studied drug, but there is an experimental drug GS 441524. These are antivirals, ie a drug for viral diseases, in this case specifically SARS, Ebola… This drug simply works by preventing the virus from penetrating through the membrane of white blood cells into their nucleus, thus simply simply preventing the mutated coronavirus from continuing to multiply and spread throughout the body. GS 441524 is the collective name for the active substance in the drug. Medicines can be obtained under the names Mutian, Shire, Curefip, SAK, Huahua, Blossom, Miner… There are many of them. The price ranges from 1800, - for a 5 ml ampoule with medicine to about 10000, - for an equally large ampoule.

You will get GS after joining the group mentioned above, so please do not ask you all of this… Don't write to me. not even write off, so I'm writing this article. If fip meets you, join the group or write to me and I will connect you with someone, I will help with the translation, but it is not in my power to explain to everyone from the basics what and how, communicate for you with drug suppliers and send money for you. It was also very difficult for me to manage it, when I knew about fipka big balls and nowhere did I find all this information about the drug kor in Czech. That's why I'm writing this mini guide on how to proceed if you're diagnosed with fip.

  1. Join the FIP warriors group
  2. Contact some Czech in the group, ask on the wall in the group for help, translation, connection with the Group Admin
  3. Payment is usually made via transferwise or PayPal, so let's all see if you're ready and you don't look at owls like I looked at when they unpacked it for me. It looks complicated, but after one payment you find that there is really nothing wrong with that.

These are probably the basic three points that you have to manage, ideally on the day you are diagnosed with fip, because how many times you play for time, and the drug travels here from abroad for some time, usually it's 3-5 days, but it can happen that the package will catch you at the border, and the consignment will be delayed for another two weeks. It is ideal to try to get the so-called admins on the site. Emergency vial, which is an ampoule from someone who has a supply and is willing to sell it to you, ideally a person who lives a short distance from you, some driving distance and is able to get the medicine to you before your order arrives. While we are waiting for the package we go somewhere to get injections and needles, we have Injekt F from Braun, they have 1ml, they are thin and do not put almost any resistance when applying the drug, and we use needles brown or green from BD microlance (watch out for length, 16ml you I think it's just that, the longer ones are fart). And when we have injections at home and ideally a drug, of course, we go to open the Internet and study how the drug is administered.

GS application - we will prepare an ampoule with liquid, an injection and a needle, which we will lock by turning so that it does not come loose for us. We will calculate the dose according to the weight of the cat (I will put the link to the calculator down in the links) and we will take the required amount, but it will always take a little more, as about 0.03 ml will remain in the needle and the tip of the injection. The drug is applied subcutaneously to the hips, around the spine, roughly in places from the shoulder blades above the buttocks. We never apply the medicine to the neck or buttocks, as it is poorly absorbed and may not work properly. We change the needle, knock out the bubbles and go for it. We catch the skin fold (when you pull the skin out you make a triangle, a pyramid) and at an angle of about 45 degrees we insert an injection into a screaming cat in the middle of our pyramid. Be careful not to shoot the skin through, the needle must be nicely under the layers of skin. Then I loosen the lashes and pull back to check if I'm injecting air or blood, if the air is a teal and we can apply GS if the blood, it means we've injected a blood vessel, we pull it out and try it elsewhere. I warn you that the medicine is quite pungent, and cats don't like it at all, so get ready for the theater in the form of a roaring cat hanging on a chandelier, chopping furiously around, bitten and scratched hands, for injections with expensive medicine flying through the air the probability that you will cure yourself of Ebola when the impact stabs you in the shoulder, than that the cat will be stabbed in peace (kor in the first days, the cats are quite pr…) I recommend treating the cat in at least two people, one holds, the other stings injection, or to produce a so-called Kitten Burrito. After the third time you manage to deliver all the medicine to the cat, make sure that it doesn't leak somewhere, how many times it just happens that you shoot the medicine next to it. We try to estimate how much has leaked and give another injection immediately, but the full dose should be given again correctly. It is also a good idea to gently rinse the cat with at least a little water instead of the injection site so that you do not have scabs, but be careful! Don't massage and don't push where the medicine is or you'll push it out and you can start playing the theater again.
Then we just make sure that the cats do not lick instead of taking bacteria under the skin…

This is how we last 84 days, and then we pray for another 12 weeks that there is no relapse and we do not have to start again, the longer the drug is used, the greater the chance that it will stop helping the cat, unfortunately… It is good at least at the beginning and before the end treatment, do a complete biochemistry, blood test, sono, and then consult a veterinarian in the group of FIP warriors if we can stop treatment after 84 injections or whether to continue for some time. And if you overcome 84 days after treatment without relapse, the percentage that the disease returns gradually decreases.

Now something else to treat Bellchi, as a lot of people have asked about some of the things I'll discuss below. We started healing Bellča last October, in a total panic I managed to find some information about GS and the FIP warriors group by some chance and miraculously, I joined, communicated the emergency vial and the first order. That's when I was told that Shire (my first emergency vial) is very hard to come by, and that Mutian is sure. The price difference between shire and Mutian is striking (shire about 2 thousand, mutian about 10 thousand.) No Bellinka is our baby, so of course we ordered a few bottles of mutian, which we had and launched the collection with Fousek. A lot of money was raised in total, and after 14 days on mutian we found a supplier of shire. At that time we were diagnosed with a second fip (yes, we also thought that the disease was ultimately contagious, but the opposite is true, both fipes are different mutations, hence two independent fipp) at our Taystee. We were really down mentally, what now, one to treat, one to die? Since there was a lot of money in the account, we decided to go to Shire, with the proviso that for the money we would put in the mutian, we could treat other cats. And so it happened, we treat two, we study, we read studies and laboratory tests, we can basically be a stateswoman when we started noticing that our Zoe has a shaggy tail .. We thought it was nothing, but if after Fever started in 14 days, it was clear to us and we went to the vet only to puncture the fluid and confirm the predetermined diagnosis. So we have a third piece. Same mutation as Taystee. To heal or not? Well, we squeezed our wallets to the bottom, and we continued with Zoe. Bellcha and I are now at the end of treatment, Zoe I Taystee is ending in February, all three are still alive, and neither of them should have been here. Throughout the hustle and bustle, we said we wouldn't publish anything about them yet, as we barely had the strength to answer questions and news about what had been going on until then.

We are currently in a phase where I am trying to study the fact that Bella has one mutation (I don't know the name from her head), sister Bunny Knock Knock doesn't have a flip, and Zoe and Taystee have a second mutation, but they are not related. All cats were tested for the presence of coronavirus before coming to our house, they were all negative, probably a mystery or something…

I hope that I wrote everything that was needed, in case of any questions I will add info to the article, excuse us that we did not inform about all the circumstances in the pre-Christmas rush, but when one hears this diagnosis in one cat that is a family member for him, he collapses the world, let alone when they gradually tell him the diagnosis of the other two, when a person refuses to give up, looks for possibilities, ways, works 20 hours 7 days a week, tries to take care of animals, household, goes to work, communicates with foreign suppliers, veterinarians, still calculates in his head, money, how much to order medicines, where, from whom, for how long it comes, for how long we have a supply, he goes to the vet a hundred km from home, measures and weighs kittens… I would give a million for some a similar article in October, when we were diagnosed with the first FIP. And now a few statistics about mothers in the end, let's not always just about Belle… We have written about 4 hours a day, in the last three months we ate about as much as an ordinary person in about two weeks, last time we sat quietly on TV about in mid-October, we celebrated the holidays with injections at the tree, New Year's Eve as if, the circumference of my belly decreased by about ten numbers, but unfortunately it's not as cheeky for me as for kittens at the beginning of treatment, at home the mess is probably still from Christmas (and one really tries) but after the whole carousel we fall to the mouth with forgiveness and one is glad that he is able to work in a car at all.

This would probably close me for the time being, I apologize for any diacritical, grammatical or other mistakes, after all we are just people and I would like to listen to any additional information that is inaccurate or untrue in the article, in the evening Bellča, ciao adios warriors and NEVER GIVE UP 😘

Links finally -

Batch calculator: https://fiptreatment.com/dose-calculator/

FIP warriors: https://www.facebook.com/groups/158363205096283/

I have studied all the information in various ways, people, the Internet, from Dr. Pedersen and his studies, everything can be found in the FIP warriors group…

Link updates:

Benefit calculator: https://www.fipwarriors.eu/kalkulacka-gs-441524/

The original FIP Warriors group no longer exists.
Try FIP Warriors CZ / SK: https://www.facebook.com/groups/fipczsk Read "About FIP and its treatment from the blog Bella does not want FIP"

New hope for cats?

Original article on Facebook Medipet Zlín.

Treatment of a fatal disease called FIP.

One of the common and very serious diseases in cats called FIP - feline infectious peritonitis (feline peritonitis), which is considered an incurable disease with high mortality, is experiencing new hope for successful and safe treatment.

FIP is an immune-mediated disease caused by feline coronavirus, which belongs to the group of enveloped RNA viruses (RNA is a type of nucleic acid that encodes the genetic material of several viruses) and has the abbreviation FCoV (feline coronavirus). The transmission of this viral disease takes place via the faecal-oral route (infectious particles are present in the faeces of an infected individual and can enter the digestive tract of another susceptible individual through the oral cavity) and are not transmissible to other animal species, including humans. The common FCoV infects the intestinal cells within which it multiplies, and in the process it can mutate (alter its RNA genetic information) within a particular cat. This new mutation allows FCoV to multiply in cells of the immune system called macrophages, a point that is becoming crucial for the development of FIP. If feline immunity cannot prevent this, a systemic immune response soon occurs, which is fatal for the cat. Factors that increase the likelihood of mutation are the potency of the virus and the weakened immunity of the cat.

FIP is always a diagnostic challenge for veterinarians around the world. Why is that so? This disease has very non-specific and variable clinical symptoms, has no specific changes in routine laboratory diagnostics, and in practice there is no available and sufficiently sensitive and reliable test to detect it.

Diagnosis is a jigsaw puzzle of several hints.

  1. Clinical signs of the disease, which are very often non-specific and present in varying intensity. In practice, 3 forms of the disease are described - wet form, dry form and form transient between wet and dry form. The imaginary is a clean dry and clean wet form at the opposite end of a wide range of symptoms. The development of a specific form of the disease depends on the immune response of the cat and the intensity of the production of antibodies, which, however, do not have a protective effect. The development of the so-called granulomatous inflammation of individual organs (granulomatous inflammation is one of the subtypes of the body's inflammatory response) is the cause of a variety of symptoms, because one specific organ is not always affected, but the whole amount and in different severity. As a result, the dry form of FIP is difficult to distinguish from other diseases by clinical examination. Increased production of antibodies leads to inflammation of the blood vessels, which leads to their disrupted integrity and the formation of effusion in the body cavities or the heart. Commonly observed symptoms include fever that does not respond to antibiotics, drowsiness, decreased food intake, wasting. Depending on the degree of involvement of the internal organs, symptoms of kidney damage (enlargement and pain), vomiting and diarrhea in case of digestive system involvement, enlargement of the lymph nodes in the abdominal cavity, pneumonia accompanied by difficulty breathing, changes in the eyes (changes in the iris) may be added. , blood in the anterior chamber, uneven pupil size, sudden loss of vision), eye examination reveals inflammation of the retina. 10% patients with FIP experience central nervous system disorders, such as gait disorders, convulsions, spontaneous eye movements, increased sensitivity to pain on normal touch, and behavioral changes. Rare symptoms such as inflammatory skin changes have also been reported. When the blood vessels are broken, an inflammatory effusion occurs, which is very important to examine thoroughly. There are transient forms of FIP that combine different dry and wet symptoms.
  2. Presence of inflammatory effusion. According to statistics, only 10% feline cats have FIP disease, so it is extremely important to rule out other causes such as heart disease, lymphoma, biliary tract infections and inflammation of the lining of the body cavities from other causes. It is often stated that the effusion is characteristic, this is not the case, and there are several variants of the effusion in cats with FIP. The most common is a yellowish, viscous effusion rich in protein and fibrin, which contains relatively few cells.
  3. Changes in the image of white blood cells. This can be changed in terms of an increase in the number and types of white blood cells, but also in terms of their decrease.
  4. Serum protein changes. There is an increase in total protein in the blood serum (this may be due to the production of inflammatory proteins and antibodies). The ratio of proteins changes and is accompanied by ratio changes of individual proteins such as albumin to antibodies called globulin. Albumin is one of the proteins in the blood serum and is formed in the liver. The albumin / globulin ratio drops below 0.8. Decreased albumin is aware of its leakage through damaged blood vessels, as well as reduced production in liver damage.
  5. Serum protein electrophoresis. This is a special test that reveals the amount of individual types of protein in the blood serum, which is not determined in a routine test.
  6. Other changes in the blood test called biochemical examination, which tells about the metabolic processes of some organs. This test is not specific, but can help us consider the severity of the patient's condition.
  7. Examination of cerebrospinal fluid in cats with symptoms of central nervous system damage.
  8. However, by determining antibodies whose interpretation has its limitations and pitfalls. The fact that a cat has antibodies against the FCoV virus does not mean that it has been mutated and thus that FIP is behind the symptoms of the disease. Most cats have antibodies to the harmless form of the virus. However, the absence of antibodies does not mean that the cat does not have FIP. Their formation depends very much on the patient's immune status. Sometimes high levels, along with other contexts, can help us diagnose.
  9. Detection of virus particles in tissues or effusions. These more complicated but available immunological laboratory methods also capture mutations in the virus itself and can distinguish the mutated from the harmless form. The problem with this method is that this test is most often performed on the cat's life and it is impossible to detect whether the virus is also present in the blood at a given stage of the disease. There is a so-called false negative result. Cats that have an effusion should always be referred for this examination when considering FIP.

Based on diagnostics, which can be costly but absolutely important, we should take a responsible view in such a serious case as FIP. The prognosis is very unfavorable, cats die on average within 16 days of the disease developing, with an average survival of 8 days. However, longer survival periods have also been described, e.g. several months with mild clinical signs. Adverse conditions include reduced quality of life, wasting, ingestion of food or only small amounts, a reduction in the number of white blood cells and a large amount of effusion. It can be said that if a cat stops eating and starts to wither in FIP, it will soon die.

Efforts have been made for a long time to develop effective vaccinations to prevent the disease, but its suffering is impossible. Vaccination does not protect against individual mutations in the virus and, in addition, dramatically worsens its course. It is not available at all today.
Today, FIP treatment includes several possible treatment protocols using drugs that alter immune responses and supportive drugs. These protocols, however, do not cure the disease.

New hope?

In the February 2019 study, the study of Dr. Niels C. Pedersen in The Highly Journal of Feline Medicine and Surgery, which tested probably the first truly successful therapy for the disease. The development of the drug was inspired by the treatment of Ebola virus and similar diseases, which are caused by viruses also belonging to the group of RNA viruses. So far, this drug is called GS-441524 and it is called nucleoside analog. The nucleoside is one of the building blocks of the genetic information of the RNA virus, this analogue can be included in its construction in exchange for the original building blocks and thus prevent its application and multiplication. It is a very small particle that can freely enter the cells of the body where the virus multiplies. A safe and curative amount of the drug was injected once daily into the cat's subcutaneous tissue for 12 weeks. In the vast majority of treated cats, there was a significant and rapid response to treatment. This treatment test was properly accompanied by regular blood tests and possible effusions, eye examinations and daily clinical examinations. In the dead animals, or animals where euthanasia was necessary due to severe deterioration in the first 2-3 days of treatment, a post-mortem examination was performed in connection with the detection of viral particles by a special examination. The result of this study was more than surprising. The treated animals improved their health and the amount of virus particles in the effluent and their amount decreased within a few hours. All cats that underwent a 12-week treatment, survived and had a good quality of life long after the end of treatment will continue to be carefully monitored for any recurrence of the disease. No systemic toxicity was observed during treatment. So far, this drug is only available in studies, but we hope that it will soon become available to ordinary patients, for whom it means a completely new hope for survival and perhaps a cure for the disease, which is still commonly fatal today.

MVDr. Katarína Novotová
Medipet Veterinary Clinic
Broučkova 5395
Zlín Read "A new hope for cats?"

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