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The often inflected drug on COVID-19 is almost identical to the feline drug from the black market

Cat owners are resorting to the Chinese black market to buy antiviral drugs for cat coronavirus.
SARAH ZHANG
MAY 8, 2020
Original article: A Much-Hyped COVID-19 Drug Is Almost Identical to a Black-Market Cat Cure

When both Robin Kintz-Fiona and Henry kittens contracted a deadly disease last year, she received reports of a drug from the Chinese black market. The use of the drug known as GS-441524 is based on UC Davis' legitimate research, but the ways to obtain it were no longer so legitimate. It was, "If you want to save your cat, send me thousands of dollars and I'll give you some unmarked vials through DHL," he says. And she did. Robin Kintz transferred thousands of dollars, received unmarked vials from China, and then applied clear fluid to the bodies of her dying cats for months.

The first noteworthy thing about the nature of the transaction is that the drugs actually worked. Henry lived almost another year, and Fiona fully recovered. Still cupped wherever she can, she is soft and alive - a miracle when we realize that veterinarians have long thought that her disease, infectious peritonitis in cats, is incurable and one hundred percent fatal. Kintz now runs a 22,000-member Facebook group that helps cat owners use the GS-441524. Thousands of cats were reportedly cured of the FIP.

The second notable thing is that GS-441524 is almost identical to the human drug so much talked about today: remdesivir, the antiviral agent that is currently our best hope for treating COVID-19, a disease caused by a new coronavirus. Although initial data suggests that the drug shortens recovery time at best, Anthony Fauci promoted a White House remdesivir. The Food and Drug Administration has approved its emergency use. And Gilead Sciences, which makes remdesivir, is donating 1.5 million doses of the drug during the pandemic.

Henry (left) and Fiona (right) were treated with GS-441524. Henry died earlier this year, but Fiona is still alive, which her owner Robin Kintz attributes to the drug. (Courtesy of Robin Kintz)

Gilead also developed and patented GS-441524. Its researchers have co-authored studies by UC Davis that show its effectiveness against FIP. However, the company refused to license GS-441524 for use in animals for fear that its resemblance to remdesivir could interfere with the FDA approval process for medicinal products for human use - originally intended for the treatment of Ebola. When this failed, and later came the global pandemic of the new coronavirus, the company began testing it against COVID-19. Remdesivir has a small but sophisticated modification that facilitates cell entry, but together with GS-441524 they have exactly the same mechanism of action.

FIP is also caused by a coronavirus - not one that causes COVID-19, but one that specializes in infecting cats. (Although humans may in rare cases pass COVID-19 to cats, humans cannot receive FIP from cats.) In most cats, this feline coronavirus or FCoV causes mild diarrhea or no symptoms at all. But in a small minority of cases, the virus infects white blood cells, and FIP breaks out fully in the immune system. The disease has two forms, and both are fatal: wet, when the cat's chest or abdomen is filled with fluid, or dry, which lacks effusion but the cat has fevers and eventually dies. For decades, veterinarians have been unable to offer anything but euthanasia.

Then came GS-441524. UC Davis trials published in 2018 and 2019 suggest that cats not only lived longer by days or weeks, but were actually cured. “It was a game-changer,” says Drew Weigner, a veterinarian and president of the Winn Feline Foundation, which funded part of the UC Davis research. “Three years ago, we were telling patients, ‘Your cat is going to die.’ Now we can tell them something different. It’s an interesting story.”

The story of a drug that was first tested against Ebola (where it failed), whose close cousin has become a groundbreaking treatment for fatal cat disease (but only illegally), and which was resurrected in a completely new virus pandemic, underscores drug development. While remdesivir has undergone clinical trials, GS-441524 has not been tested in humans for safety or efficacy against COVID-19. GS-441524 products on the black market are also incredibly expensive. A 12-week treatment for a cat can cost up to $ 10,000, depending on the brand, type of FIP and weight of the cat. In addition, there is no legal way to buy GS-441524 as a medicine - neither for cats nor for humans.

The drug would probably never have been tested on cats without the fact that Niels Pedersen, a longtime FIP researcher at UC Davis, had personally met a former Gilead executive. The two met 30 years ago when Gilead tested antiviral drugs for HIV in monkeys and Pedersen worked at a research center for primates. But Pedersen's real love has always been cats. He grew up surrounded by cats on a poultry farm. His colleague lovingly warned me that Pedersen was "irritable" and difficult to catch on the phone. But his voice softened as he talked about domesticating those cats in the barn and finding homes for their kittens.

Pedersen was fascinated by FIP while studying veterinary medicine in the 1960s, when it was still a mysterious disease with a mysterious cause. Over the decades, researchers discovered that FIP caused feline coronavirus, and then spent years trying again, but failed to develop a functional vaccine. Pedersen eventually devoted his entire career to researching the disease. When all the vaccines failed, he began to think about antivirals and think again about Gilead. The California company specializes in the development of antivirals, including Tamiflu, Truvada and many drugs for HIV and hepatitis C.

About five years ago, Pedersen contacted his contact at Gilead, and the company sent him 25 or 30 molecules from the large library of drug candidates that pharmaceutical companies usually maintain. Two of the molecules have been shown to be miraculously effective in FIP virus-infected cat cells: GS-441524 and GS-5734, the latter of which is better known today as remdesivir.

Both GS-441524 and remdesivir block viral replication. They are nucleoside analogs, meaning they mimic the nucleoside building blocks—A, U, C, or G—that make up the virus’s genetic material. Specifically, they mimic the “A” block. When a virus is tricked into incorporating a GS-441524 or remdesivir molecule instead of the “A” block, its replication process gets stuck. Eventually, no more letters can be added, and the virus can’t replicate. Where the two drugs differ is that remdesivir has an extra phosphate group that helps it enter cells and adapt to replicate. This modification is commonly used to boost the effectiveness of similar antivirals. “It’s one of those clever things that really worked perfectly,” says Katherine Seley-Radtke, an antiviral researcher at the University of Maryland in Baltimore County.

However, for some reason, this modification did not cause a difference in their effect in FIP-infected cat cells. Both molecules were effective, so Pedersen decided to continue the simpler one, GS-441524. He infected 10 FIP cats and gave them GS-441524. All 10 cats recovered.

“We almost fell off our chairs,” says Weigner. That is funny , he recalls. This may not work well. Wait, wait, stop, come back? What has happened? The initial study was small and under artificial conditions, but in a subsequent rigorous trial of 31 pets with naturally occurring FIP, 25 cats fully recovered at an unprecedented rate. Pedersen had previously tested another antiviral drug at Kansas State University, but only seven of the 20 cats were in remission. These results seemed impressive at the time, but GS-441524 appeared to be even better.

Pedersen is now 76 years old and has spent 50 years of his career researching FIP. Finally, a cure seemed within reach. “I felt really good,” he told me, “and I thought it was a good milestone for my career.” But the pinnacle of my career didn’t happen, at least not in the way he had hoped. Despite its success, Gilead refused to license GS-441524 for use in cats.

While Pedersen tested GS-441524 on cats, on the other side of the world, another virus raged in West Africa - the human virus: Ebola. The virus that causes Ebola is not a coronavirus, but remdesivir is an antiviral drug with a broad spectrum of action, and the first results against Ebola were promising. In fact, so promising that the company was considering FDA approval regarding remdesivirus in humans.

According to Pedersen, Gilead feared that cat research could hinder the remdesivir approval process. Because GS-441524 and remdesivir are so similar, it may be necessary to report and investigate any side effects found in cats to ensure the safety of remdesivir in humans. Gilead's best practice in generating unnecessary cat data is standard industry practice. "One of the rules when developing drugs is to never take a test that you don't have to do if the results could be problematic," says Richard Sachleben, a retired pharmaceutical researcher. Gilead declined to comment on the story.

Pedersen found the explanation difficult to accept. “It was a blow,” he said. “It hits you hard, especially when you don’t see any reason for it.” He continued to publish the studies, as academics do, and the results became public in 2018 and 2019.  

Shortly afterwards, Pedersen heard from certain people in China that one company wanted to buy the drug from Gilead. She asked Pedersen to be a mediator. Although the company did not obtain a license, it still started selling the drug at FIP and its exact formula is unclear. Other companies explicitly advertise their formulations as GS-441524. China has a large pharmaceutical production base and the synthesis of crude GS-441524 is not particularly demanding. FIP is also a growing problem in the country as cats - especially purebred cats, which are more susceptible to the disease - are becoming increasingly popular in China. A black market emerged that filled the vacuum left by Gilead.

The use of the Chinese drug was initially controversial in the FIP community. “I got a lot of hate mail for it. I lost a lot of supporters,” says Peter Cohen, an early supporter of the drug. Cohen runs ZenByCat, a nonprofit that raises money for two groups that fund FIP research, SOCK FIP and the Winn Feline Foundation’s Bria Fund for FIP Research. Previous iterations of Facebook support groups, such as FIP Fighters, also initially banned any discussion of black-market drugs.

Susan Gingrich, a former administrator of the Facebook group, has focused her efforts on pressuring Gilead. Gingrich, whose brother is former House Speaker Newt Gingrich, is also the founder of the Bria Fund. Her cat, Bria, died of FIP in 2005, and she started the fund that same year with the help of her brother and her husband. “It would have been a lot easier if Gilead had marketed the drug or allowed someone else to market it,” she says. Gingrich bought Gilead stock after early research on GS-441524 showed promise. In June 2019, she wrote a letter to Gilead, as well as to President Donald Trump and her Tennessee congressman and senator, imploring the company to approve the drug for use in animals. She says she has not received a response.

When Kintz tried to save Fiona and Henry, she asked about GS-441524 in one of those Facebook groups that banned the discussion about the drug. Her contribution to the group led nowhere, but two women privately sent her advice. Kintz eventually formed a new group, now called FIP Warriors, so that its members could exchange tips and feedback on various brands of drugs. The group has grown to 22,000 members on Facebook - as well as 25 administrators and 26 moderators. It has satellite groups in various countries and languages around the world. "We sometimes feel like a global company," says Kintz, a design consultant in New York State. If he is offline, say six hours, he will notify his fellow administrators and moderators. Facebook has become a non-stop international organization.

FIP Warriors also has a network of emergency group chats for each state. Because transportation from China can take a long time and because the sooner GS-441524 treatment begins, the better, the emergency huts connect the new members with those who have free injection vials with GS-441524.

Zina Lemesh, a New York City lawyer and cat breeder, joined the group in February when her cat, Nora, turned yellow and stopped eating, her belly swelling like a balloon. Lemesh recognized the symptoms of wet FIP and knew it was a hopeless disease. She was about to call her vet about euthanasia when she came across the group while frantically searching online for a treatment. She filed an emergency request for GS-441524. “I was in touch with someone within 10 minutes,” she told me. “Within two hours, my cat had received its first dose.” And within a few days, Nora was eating again. She’s almost at the end of her 84-day treatment. Her swollen belly is completely gone.

“This is a cat mom and a lawyer talking at the same time, and I’m trying to balance those two personalities in my brain, but it’s hard,” Lemesh said. On one side is the cat mom who would be very keen to save her cat; on the other side is the lawyer who is focused on the rules and can’t believe she injected her cat with an unlabeled drug from a stranger. But if it was between letting Nora die and the slim chance of saving her, the choice was clear. Of course, Lemesh told me she would rather go the legitimate route — if there was such an option. “Do you think people would want to send $7,000 to $12,000 to some strange entity?” she said. “Or would they rather pay their vet?”

The availability of GS-441524 on the black market makes it harder for veterinarians. They cannot prescribe the drug or buy it legally for cat owners. Some agree to help owners with injections that can be difficult and painful for a cat. But others do not want anything to do with an unapproved drug. Linda Pendergrass-Nethery, who lives in Chattanooga, Tennessee, told me she had to change her vet. According to her, her first veterinarian refused to help. The other prescribed sedative gabapentin to cure his cat Sundance with injections. So every afternoon, a few hours before the daily Sundance injection, Pendergrass-Nethery and her husband gave him a dose of gabapentin. When the time came, they wrapped him in a white towel - "like a mummy," she said - and stabbed him with GS-441524. It's definitely a job for two people.

Meanwhile, FIP Warriors has grown so large that Chinese vendors are now approaching the group to market their GS-441524. Sometimes they appear and then disappear. “It’s hard to tell if they’re companies or just dealers,” Kintz says. But the group has tried to establish some level of accountability. It’s trying to test a few popular brands to verify the concentration and content of the drugs with GS-441524. When new vendors come forward, the group asks for samples to send to owners who can’t afford GS-441524 for their cats, who would otherwise surely die of FIP. “That’s how we generally determine whether it’s going to work and whether it’s going to be okay,” Kintz says. But the group also declines full responsibility, since it can’t verify every specific drug.

Case in point: This January, a popular brand of GS-441524 medication seemed to be killing cats given it. When the group noticed, the administrators began collecting data and warning about the brand’s latest batch. The man selling it online disappeared, and several members of the group posted that he still owed them money. It was said that he and his wife had gone through a tumultuous divorce; she was the brains of the operation, and he tried but failed to keep the business going. Then a new brand of GS-441524 appeared—supposedly made by his wife. It’s impossible to verify all of this from the other side of the world. “It’s really like the Wild West,” says Kintz.

The recent increase in interest in remdesivir could change some of this momentum. After studies with Ebola proved to be of little use, remdesivir became a cure for another (human) disease. If remdesivirus is properly FDA approved beyond the emergency use for COVID-19, and if it is common to prescribe and distribute it through a pharmacy, veterinarians could legally use it for cats. "It may be five years since COVID may be a distant memory, and then it may be able to be used for FIP," says Weigner. At least for now, there is a lack of data on remedivirus for cats.

Kintz hopes that GS-441524 may one day be legally available to cats. At the same time, he says: "No one would need me anymore, but that's okay."

We want to hear what you think about this article. Write to the editor or write to letters@theatlantic.com.

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Cats and ferrets sensitive to SARS-CoV-2

Researchers say infecting dogs, pigs, chickens and ducks is unlikely.

Shawna Williams
2.4.2020
Original article: The Scientist

Both cats and ferrets can be infected with SARS-CoV-2, the virus that causes COVID-19, and can spread the infection to other members of the same species. Preliminary study published on 31.3.2020 shows that ferrets can be a suitable laboratory model for studying the disease (scientists they actually use ferrets in its SARS-CoV-2 studies), but experts say it does not reveal whether pets can transmit the infection to humans.

In a study that was not peer reviewed, the researchers inserted virus particles into the noses of a small number of cats. Four days later, they killed several animals and tested the organs for the presence of SARS-CoV-2 genetic material. They found viral RNA in cat noses, soft climates and tonsils, but not in the lungs. Other infected animals were housed in cages near uninfected animals. The researchers later found viral RNA in one of three cats located near the infected cat.

A team led by Zhigao Bu of the Harbin Veterinary Research Institute (China) also performed tests on ferrets, dogs, pigs, chickens and ducks and found viral RNA in ferrets after exposure to SARS-CoV-2 virus. Two of the five exposed dogs had viral RNA present in the rectal swab but not the oronasal swab after two days, while none of the pigs or poultry tested had viral RNA confirmed.

Jonathan Ball, a virologist at the University of Nottingham in the UK, told for The Guardianthat cats have similarly been found to be susceptible to infection by the virus that caused the SARS outbreak in 2003 and is related to SARS-CoV-2. "But we should keep in mind that cats do not play a big role in the spread of this virus, if any at all," he said. "Human-to-human transmission is clearly the main mode of spread, so there is no need to panic about cats as a major source of infection. Of course, if you think you have a Covid-19 and you share a household with a cat, then it would be wise to limit close contact with your furry friend until you are better off. "

Virologist Linda Saif of Ohio State University interviewed by Nature stated that none of the infected cats showed signs of disease and that only one in three cats housed near the infected cats had been infected with the virus. "This suggests that the virus may not be highly transmissible in cats," he says.

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Pine's statement on the relationship with CureFIP

Dear clients,

Due to the COVID-19 crisis in the world, many flights have been canceled and, as a result, there has been a delay in our courier service, for which we apologize. We understand that many cat owners in the US and Europe are out of stock and some clients have ordered a brand name called "Pine" from the CUREFIP website. Despite treatment with "Pine"
the drug proved ineffective, the cats began to weaken and some even died. We would like to make it clear that we have NEVER worked with the owner of the CUREFIP website to sell our medicine. We have nothing to do with CUREFIP. The owner is a Chinese American named Leon Li and his Malaysian business partner Rebecca. They both live in Malaysia. They use the CUREFIP brand, where they falsely declared that they were selling PINE, even though they were actually selling another product to their clients at a very high mark-up. In addition, the cat owner does not know how to use the medicine and the recommended dosage, which varies depending on the weight of the cat. The negligence and lack of interest of CUREFIP can make your pet's condition worse.
The owner of CUREFIP started a business based on lies about the fact that FIP has a positive cat and that he runs a shelter. He is rude to clients and commits fraud. We asked them to remove the photos and product names from the website, but refused. Contact your sales representative to order the actual drug and ask to order from this fraudster. I hope that all FIP cat owners will stick together and stop ordering from CureFIP. We hope all your beloved cats will recover soon!

Fight FIP, Fight COVID-19.

PINE

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Dr. Pedersen on the relationship between Remdesivir and GS441524

Original article: SOCKFIP

Dear veterinarians, cat owners and the public,

I am still asked about the relationship between GS-441524 and the very promising treatment for Covid-19 - Remdesivir. GS-441524 is a biologically active ingredient in Remdesivir and has been commonly used worldwide for the safe and effective treatment of feline infectious peritonitis (FIP) for over 18 months. FIP is a common and fatal coronary heart disease in cats. GS-441424 and Remdesivir are almost identical drugs. Remdesivir is a form of GS-441424 that Gilead Sciences has decided to use in humans to treat COVID-19, and clinical trials are currently underway in China, the United States, and several other countries. Remdesivir is called product. The prodrug is transformed by infected cells into the active ingredient, which in this case is GS-441524 with the addition of one phosphate group (i.e. GS-5734). Gilead researchers slightly modified GS-5734 to protect the added phosphate group and allow absorption into the cells. This form of GS-441524 is known as Remdesivir. Upon entering the cell, its enzymes remove protection to give GS-5734. GS-5734 is further activated in the cells by the addition of two additional phosphates to form the triphosphate form GS-441524. This is a molecule that inhibits the production of viral RNA. We decided to use GS-441524 to treat FIP because it had the same antiviral properties as Remdesivir and at that time Gilead Sciences did not anticipate its use in humans. GS-441524 is also much cheaper than Remdesivir. Therefore, there was no apparent conflict between the use of one form for cats and another form for humans. However, Gilead believed that our research on cats would affect the approval of Remdesivir for use in human medicine and refused to allow GS-441524 for the treatment of animals. This refusal, coupled with the desperate need for FIP treatment worldwide, led to the Chinese black market with GS-441524. FIP is a major problem for domestic cats in China, and Chinese cat owners have demanded FIP treatment even more desperately than owners in other countries. The first papers describing the treatment of FIP with GS-441524 were published in 2018 and 2019, and thousands of cats have since been treated. Despite this experience, the medical community, including researchers, was apparently unaware of the use of GS-441524 to treat FIP and its relationship to Remdesivir. Veterinarians have considerable but underappreciated experience with coronaviruses, coronavirus diseases and vaccines in pigs, calves and poultry. Ferrets also suffer from a serious FIP-like disease caused by their own coronavirus species. What happens to GS-441524 for cats if Remdesivir is shown to be safe and effective in treating Covid-19? GS-441524 is the first critical step in the production of Remdesivir and it is logical to assume that it will lead to the existence of competition in its use for cats and humans. On the positive side, the worldwide approval of Remdesivir may also help to change the opposition to the granting of rights to use GS-441524 in animals. If Remdesivir were approved for human use (although not approved by GS-441524 itself), it could also become legally available for use in veterinary medicine. However, the safety and efficacy of Remdesivir for the treatment of FIP have not been established.

-Niels C. Pedersen, DVM, PhD, School of Veterinary Medicine, UC Davis ..

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A vaccine to prevent FIP in its infancy.

Original article on dvm360.com, published 18.3.2020.

Researchers at Colorado State University want to stop the feline enteric coronavirus before it has a chance to mutate to the feline infectious peritonitis virus.

A new candidate in the fight against feline infectious peritonitis (FIP) may soon enter the scene. Researchers at Colorado State University (CSU), funded by the Morris Animal Foundation, are developing an oral vaccine to beat the disease by targeting feline enteric coronavirus (FECV) - a highly contagious and common virus that can accidentally mutate to FIPV.

“Vaccination attempts that have been made in the past have targeted FIP, but that’s too late,” Gregg Dean, DVM, PhD, chair of the Department of Microbiology, Immunology and Pathology in the College of Veterinary Medicine and Biomedical Sciences, told dvm360. “We know that enteric coronavirus replicates at an amazing rate. So it’s likely that it will mutate into the virus that causes FIP—so there’s more going on inside the cat than is being transmitted between cats. If we can control that replication, we might be able to prevent the mutant from emerging.”

It's all about the gut

As a first step toward understanding what a vaccine would have to do to stimulate a protective immune response against FECV, Dr. Dean and his team studied cats that had been naturally infected with the disease, specifically looking at their mucosal immune responses. “Enteric virus is quite restricted in where it replicates, and that is, as we know, in the intestinal tract,” he explained. “So understanding the immune response at that site is critically important.”

The vaccine design reflects this insight. The vaccine will be administered orally and includes the bacterium Lactobacillus acidophilus, a probiotic found in some foods and in the gastrointestinal tracts of many animals. “The role of probiotics is essential,” said Dr. Dean. “Some probiotics stimulate the immune system naturally, and by combining the antigens from feline coronavirus with the natural immunostimulatory activity of the probiotic, we hope to induce a protective and lasting immune response.” He explained that the probiotic’s effect is enhanced by the fact that it is alive and replicating. “It also produces antigens – in our case, feline coronavirus antigens – so it is very economical,” continued Dr. Dean. “We don’t have to use expensive processes to produce large quantities of antigen. We are using the natural activity of the bacteria.”

Dr. Dean and his team plan to begin the first trials of the FECV vaccine this fall. “We’re going to give the vaccine to cats in a colony environment where enteric coronavirus naturally circulates. We’re going to take new kittens, vaccinate them, and then see if they get FECV,” he said. “Almost every cat, and probably every cat in that colony, is infected.”

Disease recognition

Meanwhile, Dr. Dean is leading another study funded by the Morris Animal Foundation with a different but related goal: to develop a new diagnostic test for FIP that is accessible, inexpensive, and rapid. “As we move closer to real, viable treatment options for FIP, an accurate diagnostic test will be an important part of that decision-making process,” he explained. “Early diagnosis will be important as long as effective treatment is available.”

Instead of focusing on the cat’s immune response or looking for the virus itself, Dr. Dean and his team are looking for specific biomarkers that are unique to FIP infection. They have identified 18 proteins that appear to be common in cats with FIP, and they are in the process of validating them. If the test is successful, all that will be needed is a blood sample from the patient. “We still have a lot of work to do, but it’s a top priority for us,” he said.

We have a lot of work to do

With these exciting prospects for cat health on the horizon, Dr. Dean praised the past and present work of his veterinary colleagues: "There are a lot of people who work hard to solve these important problems for cats, and it is the excellent work of this community that leads us all to a common goal."

Sarah Mouton Dowdy, a former dvm360.com editor, is a freelance writer and editor in Kansas City, Missouri.

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UC Davis professor claims that half a century of coronavirus study is neglected

Original article: UC Davis professor says his half-century of work studying the coronavirus is being neglected;(27.2.2020)
Translation: 18.1.2021

After half a century of studying the virus, a 76-year-old doctor was able to come up with a vaccine for cats two years ago.

DAVIS, Calif. - Coronavirus is associated with COVID-19 in the minds of many people around the world, but doctors say coronaviruses have been with us for decades.

Professor Dr. Niels Pedersen of UC Davis in California studied the virus for half a century. His focus? A specific strain occurring in cats causing feline infectious preitonitis (FIP).

"At one time it was a relatively unusual disease, but highly fatal for cats, full of mysteries and therefore very interesting," Pedersen explained. "So, among other things, I made it my life's work."

After half a century of studying the virus, a 76-year-old doctor was able to come up with a vaccine that is currently being used effectively to treat cats.

It is a drug that he thinks could be used to treat coronavirus in humans, but it is not a cheap affair for pet owners.

"The treatment consists of giving an injection for 12 weeks, which can cost up to $ 10,000, but there are thousands of people who have already treated their cats," he said.

However, Pedersen says his research and work are being ignored.

"It's also strange that much of what we've already learned through FIP in cats at this time can be applied to human COVID-19, but it's overlooked," Pedersen said.

Pedersen said that if a vaccine is currently being prepared for humans, public health officials do not necessarily have to rediscover the wheel.

"Knowledge about these vaccines can be used for all vaccines that will be developed for humans in the future," Pedersen explained.

Watch the conversation at  Facebook with Lena Howland.

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Answers by Dr. Pedersen to e-mail questions from patients treated with GS441524

https://www.zenbycat.org/blog/dr-pedersens-faqs-about-using-gs

Please note that these answers were provided by Dr. Pedersen individual cat owner. Consider them as a useful guide and not as individual veterinary advice. In no case do they replace standard veterinary care.

General questions about GS-441524 injection

What if my cat doesn't respond to GS immediately or her behavior doesn't change after a few weeks on the drug?

All we can do is watch what is happening over the next few days and hope for the best. If increased pain develops at the injection site, it is possible that this is the cause of the symptoms we are seeing. If the place is sensitive to touch, it goes without saying that it bothers the cat. It is possible that the situation will worsen and an open wound will form in the painful area, or it will improve quickly. Even if no one wants severe reactions at the injection site, injection is still a better choice.

My cat is experiencing “ups and downs” during treatment. Sometimes she seems full of energy, other times she is lethargic. Is this normal?

The most dramatic improvement usually occurs in the first week, or the first two, after which the process slows down. Do these cycles show that the cat is less active after the injection and more active a few hours after the injection? During our tests, we noticed that some cats seemed a little depressed and depressed after the injection. A higher dose worsens the situation. If it is a relapse, the reaction is even more pronounced, but if it is really just a reaction to the drugs, we will have to wait and see what happens after the end of treatment.

What should I do if my cat feels increased pain at the injection site from using GS? Would lidocaine or anything else help with the pain?

We are working to change the diluent for the drug to reduce stinging and pain, but it will probably take several more months and it will only solve the problem with the diluent and the effect of the drug itself. Applying lidocaine cream to the post-injection area is like locking the barn door after the horses get out. We tried to use it at the injection sites before treatment, but the owners who tried it were not satisfied with the results and stopped using it.

Is it safe / appropriate to continue administering FIO (feline interferon omega) concurrently with GS?

It won't help, it won't hurt either.

Should my cat continue in pre-zone with GS?

Not. You can stop prednisolone after a few days. A cat with FIP should respond very quickly to treatment and no other medication is needed at this time unless clearly indicated.

What are the chances that after a cat is cured of FIP, it will become infected again with a coronavirus that mutates again to FIPV? Should I treat a cat that secretes coronavirus?

Although theoretically possible, we have not yet seen the FIP-cured cats develop the disease later. Therefore, I would focus on curing your FIP positive cat. Do not treat a cat that only secretes enteric coronavirus. This cat has a very low risk of developing FIP and treatment with enteric coronavirus carriers will only promote the occurrence of drug-resistant strains.

Should I vaccinate or neuter my cat during GS?

Vaccination or castration is not required during treatment. Healing the cat is paramount. There will be plenty of time after treatment to resolve the issue of castration. Personally, I am not a strong supporter of FVRCP vaccines (polyvalent vaccines) or the need to vaccinate cats against rabies (unless required by state or local legislation) or administering FeLV to cats that are at low risk for infection. If we treat a cat with FIP, it should be treated in accordance with standard professional care, locality (rabies) and your practice. In short, treat the cat like any other cat, but have it cured first.

Questions about what will happen after the end of GS treatment

My cat has been with GS for several weeks and she seems to be doing well, but the titer of coronavirus antibodies is still high. Does that mean she's still sick? Should I be worried?

We do not see the coronavirus antibody titer value for you, so I cannot answer your question. However, we would expect it to take many months for permanent remission to occur. The fact that the titer is still high at this early stage does not worry us, but it may be something that should be monitored to catch a possible relapse.  But we are optimistic. Symptoms indicate complete remission, and just as importantly, the cat has gained weight and figure in recent weeks. These were also favorable symptoms in our other cases, which did not suffer from a neurological disease. The high titer of the coronavirus also reflects the intense response of the immune system to the FIP virus. It is desirable for this titer to remain high for a while and then slowly return to a much lower titer.

What if your cat relapses after you stop taking GS? How do I find out? (Question about a neurological cat)

We hope that your cat will remain healthy after the end of treatment, but we must also prepare for a possible relapse. Relapses can occur within 1-84 days, based on our experience with other cats we have treated. The clinical signs of relapse will be evident in neurological cases, and will be essentially a recurrence of the same problems. They get a fever, the cat stops eating, becomes less active and the neurological symptoms she had before return. It is important to document what is happening. You can also measure her temperature every day for several weeks and then every other day until we reach day 84. During this period, it will be important to monitor the cat's level of activity and weight.

What thermometer should I use to measure the temperature of a cat?

I prefer digital rectal thermometers, which are characterized by high measurement speed. Do you measure temperature during rest and not after a certain time of physical activity? Temperatures may vary. One is higher, one is higher.

I noticed that after the GS was discontinued, the cat's temperature rose sharply. Does that mean the cat has relapsed?

Cats and other small animals are not as consistent in their systemic temperature as humans, and the fluctuations you see are not uncommon. The problem is that the more you worry, the more you measure the temperature and the more of these fluctuations you will see. For this reason, we are not very afraid of these fluctuations. It is much worse when temperatures are consistently higher than 39.5 ° C. It is important to note the overall condition of the cat, its appetite, activity levels and clinical signs. In short, fluctuations like these are fine unless they become permanent and are associated with loss of appetite and activity. If your cat is otherwise well and there is no evidence of a persistent fever, we recommend that the cat be only at home, where it is possible to protect it from unnecessary stress and monitor it closely. 

Questions about laboratory results during or after GS treatment

My cat is being treated with GS and her lymphocyte count is high. That's all right?

The lymphocyte count is only slightly higher than normal, but in reality it is good. A low lymphocyte count would indicate that the infection is active and severe, while a high number would indicate that it elicits an immune response.

My cat has been on GS for several weeks and laboratory reports have increased creatine kinase and phosphorus. Is this a problem?

It doesn't have to mean anything if urea and creatinine are in the normal range. High phosphorus content may not mean anything yet. I recommend checking the values in a month.

We are concerned about the seemingly rapid increase in urea and creatinine in the blood. Do you have any other recommendations, or do you just need to supplement your fluids / diet and hope that the progression of kidney disease will slow down, as it is a young cat and it seems that the FIP has been successfully cured?

Yes, there is evidence of kidney damage and given the recent change and the fact that your cat is being treated this way, I think your cat may have suffered mild kidney damage. We only observed kidney damage that was milder than this in one of the more than 30 cats we treated for a total of 12-36 weeks and even at higher doses than you used. However, this type of medicine is known to be toxic to the kidneys in some people treated for HIV / AIDS or hepatitis C. This damage is reversible if you stop treatment early enough, and I assume you have already stopped treatment. If not, and you are at the end of 12 weeks or close, quit it. It does not reduce the chance of healing. Make sure the cat has access to water, and if her appetite is affected, feed her a moist diet that she likes with added water. Cats love wet food with juice and you can still mix a little extra water. There is a commercial and domestic diet for cats with kidney disease, but it is not very tasty and does not cure the kidneys, but rather protects the remaining kidney tissue. I would also make sure that your veterinarian does a urine test to find out what the specific gravity is - the lower it is, the greater the kidney damage. The more water cats drink and the more they urinate, the greater the kidney damage. It is necessary to determine whether the urine contains any signs of bacterial infection in the urine sediment or after cultivation - if they are found, antibiotics should be used immediately.

Questions regarding the oral form of GS

Some companies produce GS in tablet form. Is this form safe / effective?

Yes, at least one company in China also produces the oral form GS-441524, which it claims will work just like injections. This is not surprising, since the modifications required to convert injectable drugs into an oral form are well known. All drugs for HIV / AIDS and hepatitis C were also transformed into an oral form. However, like many others, you may find it more difficult to give tablets to cats than to inject. They usually adapt to the injections over a short period of time, but if they don't agree with the pills, it still gets worse and worse. Therefore, if you go this route, do not invest much in it until you are sure that you will be able to give the tablets to your cat.

Companies that make the oral form recommend splitting the dose and giving it twice a day. Why?

I do not know anything more about the oral form of GS, so I cannot provide a reliable answer to this question. However, there must be a reason why this Chinese manufacturer tells people to give GS twice a day and not once a day. Maybe it's because putting it all at once is too much of a burden for the cat system. It does not make sense to think that the medicine is excreted from the blood more quickly when given orally, which is another possible reason why they want to split the dose. It is important to me that these people are pushing hard for the oral form of the medicine, but have not provided any preliminary information on the success or tolerability, nor have any clinical trials been conducted.

 Is there a risk of alternating injection and oral forms of GS?

It would probably not be appropriate to alternate these forms on a daily basis. But there is probably no problem with the transition from one form to another. The diluted drug in injection form usually contains 15-16.5 mg / ml and the dose for cats is 4 mg / kg, SC.

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Influence of surgical vs. of hormonal castration and routine vaccination for the treatment of FIP with GS441524 - NC Pedersen

Original article: https://sockfip.org/miscellaneous-advice-hormonal-neutering-and-vaccines/

The problems associated with adverse sexual behavior in intact cats and males during GS treatment have caught my attention. The questions often come from countries where castration is either postponed or not part of common practice. There are also frequent questions about routine vaccinations. There are concerns that stress during castration / sterilization or vaccination may affect the outcome of GS-441524 treatment. I am convinced that such fears are exaggerated. If a cat is treated and in remission, or is considered cured, it can be neutered, but preferably in the least stressful way. Cats can be neutered and returned to their homes quickly and efficiently on the day of neutering with a minimum of preoperative, surgical and postoperative treatments and restrictions (eg caging, e-collars). Such surgeries will be less stressful for cats (and owners whose behavior is reflected back on their cats) than intolerable sexual behavior alone.

I am not in favor of hormonal treatment to prevent inappropriate sexual behavior in cats, and I think that effective castration will be less stressful in the long run than such prevention. Therefore, if a permanent change in this behavior is required, surgical castration is always better than chemical castration.

Is it better to neuter cats if they still have some part of the treatment in front of them, provided they look healthy and blood test results are normal? Yes, castration during treatment makes sense. However, we do not recommend unreasonable resumption of treatment during surgical castration during the 12-week observation period after the end of treatment, the so-called post-treatment. Castration is unlikely to change the fate of a cat with FIP, as the cure for FIP is given by the very cessation of treatment. The observation period is not intended to further improve, but only to confirm the cure.

Some owners of cured cats do not want their castration for breeding purposes. We know that genetic and environmental factors also affect FIP, which has led to the recommendation that purebred cats that give birth to kittens with FIP should not be used for breeding. This should be even more true for cats that have been cured of the FIP.

When it comes to vaccines, many already know that I am not a big supporter of vaccines for cats after reaching adulthood, nor of boosted vaccines in the first year. I also think that rabies vaccines are not justified for normal use in cats, neither in terms of public health nor in cats. Nevertheless, I am aware that these views are not generally accepted and that laws in some states require rabies vaccinations against cats. In any case, we did not notice any consequences of vaccination in any of our cured cats. However, this is not something I would recommend for cats in treatment. The immune system of these cats is responsible for other things than responding to the vaccine.

When are drugs other than GS-441524 indicated for the treatment of FIP? - NC Pedersen

There are often questions about the need for complementary medicines to GS-441524. Initially, supportive (symptomatic) treatment may be needed to keep cats alive long enough for the antiviral effect to take effect. Drugs often used in this early stage usually include antibiotics (doxycycline / clindamycin), analgesics (opioids, gabapentin), anti-inflammatory drugs (corticosteroids, NSAIDS), immunostimulants (interferons, non-specific immunostimulants) and fluids. I have tried to avoid excessive use of these drugs, except for their temporary use, and only if there are legitimate reasons for their use, especially in severely ill cats during the first few days. The most important goal of FIP treatment is to stop the replication of the virus in macrophages, which immediately stops the production of numerous inflammatory and immunosuppressive cytokines that cause the symptoms of FIP. While some drugs, such as corticosteroids (prednisolone) or NSAIDS (meloxicam), can inhibit inflammatory cytokines, the only drugs that completely inhibit these harmful cytokines are antivirals, such as GS-441524 or GC376. These drugs lead to a dramatic improvement in fever, activity, appetite, etc. within 24-48 hours. This improvement will be much more pronounced than with any other medicine. Therefore, unless there are reasons to take other medicines, they should be discontinued as soon as there is a significant and stable improvement in FIP symptoms. I'm not even a supporter of the supplements that cats often take during treatment. B12 only treats B12 deficiency, not FIP anemia. This also applies to a wide range of nutritional supplements and many types of special cat food. Follow the proven commercial brands of cat food supplemented with animal meat.

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INAPPROPRIATE USE OF GS-441524 IN AN ATTEMPT TO ELIMINATE FELINE ENTERIC CORONAVIRUS (FECV) FROM HEALTHY CATS

Niels C. Pedersen, DVM PhD
University of California, Davis

Original article: INAPPROPRIATE USE OF GS-441524 IN AN ATTEMPT TO ELIMINATE FELINE ENTERIC CORONAVIRUS (FECV) FROM HEALTHY CATS

Mutian, the first Chinese company to sell GS-441524 on an unapproved market, recently advertised that using its oral formulation for one (or more?) Days would stop the fecal excretion of FeCV in healthy cats. Some veterinary researchers also take this approach. The reason is to prevent the formation of a mutant virus causing FIP (FIPV), and thus to prevent FIP. Although this approach is at first sight attractive, it is a very incorrect introduction of GS441524 in cats. Until now, GS441524 has only been recommended for the treatment of cats suffering from FIP. There are many problems associated with this approach.

In his advertisements, Mutian suggests that FeCV can be easily eliminated by a simple administration of oral GS441524. However, it does not talk about possible research that led to this approach. There is currently no published field research to demonstrate whether chronic FeCV excretion can be permanently cured by healthy cats. 40% or more individuals in any population of multiple cats may be positive for this virus. Naturally occurring FeCV infection appears at an early age and is not associated with any significant symptoms of the disease. Virus shedding takes weeks, months, and in some cases indefinitely, but in most cats it eventually stops building immunity. However, once immunity is stopped, antibody levels fall and cats become susceptible to infection again. This cycle of primary and secondary infections occurs in many cats throughout their lives. GS441524 treatment is very unlikely to result in more permanent immunity than is seen in nature. It would not be important if FeCV was short-lived in the environment and would not be easy to transfer to clothing, rubbish, hair and other items. FeCV survives in the environment for up to 2 weeks and transmission by contaminated objects is well documented. Therefore, although it is possible to treat FeCV in a particular cat, the virus easily returns to the population. This has also been documented in the experience of isolating mothers and prematurely weaning their kittens, which is a slightly similar strategy to preventing FeCV infection.

Although our current knowledge of FeCV infection calls this approach into question, there may be more compelling reasons not to treat healthy cats with GS441525 or any other safe and effective antiviral drugs in the future. It is unlikely that the excretion of FeCV can be stopped for a significant period by a single or short-term treatment, as stated, and this will undoubtedly require a longer period. This approach will be extremely expensive if applied to a large number of cats in a kennel, shelter or rescue station.

The most important reason to avoid this FIP prevention approach is the problem of drug resistance. We already know that some cats with naturally occurring FIP are infected with one or more GS441524-resistant FIPV strains. Our field experiment with 31 cats found that one was infected with a virus that was highly resistant. There is laboratory research confirming that resistance can develop very easily in cell cultures. Drug resistance is also well known in viral diseases such as HIV / AIDS and in people infected with the hepatitis C virus. The fastest way to achieve resistance to any microbes, including viruses, is to overuse drugs where they are not needed. The problem of antimicrobial drug resistance is sufficiently confirmed by our experience with bacteria in animals and viruses in humans. There is no doubt that overuse of drugs such as GS441524 in large groups of healthy cats will lead to a positive selection of FeCV strains that are partially or completely drug resistant. This resistance is also manifested in the mutant FIP-causing FeCV virus (FIPV), which precludes the use of GS441524 in a larger number of cats with FIP. Unfortunately, veterinary medicine does not have the resources of human medicine or financial incentives to discover, test and obtain multiple drug licenses in order to circumvent the acquired drug resistance.

I urge cat owners and scientists to refuse to use safe and effective antivirals in this way. I have nothing to do with voracious drug manufacturers who prefer profit to serious science, common sense and the fears of cat owners suffering from FIP now or in the future. There is a saying, "Just because we can do something doesn't mean we should." NC Pedersen

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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 the coronavirus does not mean that it has a tick... I think the picture below from the PhD thesis study of Els Cornelissen (Promoter: Hans J. Nauwynck) Title: "Immune evasion of feline infectious peritonitis virus-infected monocytes" describes it best.
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

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