Feline infectious peritonitis (FIP) is an infectious disease of cats, predominantly young cats. It occurs when feline enteric coronavirus multiplying in the intestines undergoes a critical mutation which changes its tissue tropism from enterocytes to macrophages. FIP virus then moves round the body in macrophages – the ultimate Trojan horse mechanism. This leads to a disseminated infection and the development of a fibrinoid necrotising vasculitis and serositis due to deposition of immune complexes consisting of cat antibodies and FIP viral antigens. 

After the promising results of adenosine nucleoside monophosphate prodrug GS-5734 usage to prevent some RNA viruses, the efficacy of its parent nucleoside GS-441524 against FIP (feline infectious peritonitis) started to be evaluated. This small molecule interferes directly with replicative processes encoded by the virus.

For optimal results, the medication dosage should remain the same even if the cat's weight decreases. However, if the cat's weight increases during treatment, the dose needs to be adjusted based on the initial weight or the highest weight during the treatment cycle.FIP is a serious disease, but early detection can help improve the chances of a positive outcome.If your cat is showing FIP in cats symptoms, please take them to your nearest veterinarian for proper diagnosis and treatment

Feline infectious peritonitis (FIP) is a viral disease caused by feline coronavirus (FCoV). This virus is a mutant of feline enteric coronavirus (FeCV) which cannot be easily defeated through a cat's natural immune response. FCoV will infect white blood cells and spread through the cat’s body. The disease is progressive and can be fatal if left unattended. It is estimated that this disease can kill 1.4% of cats around the world.FIP can be divided into two categories, the effusive (wet) form and the non-effusive (dry) form. Common symptoms of FIP include loss of appetite, fever, depression, and weight loss. Cats can evolve from one FIP form into another form from time to time.

The initial field testing of GS-441524 for FIP treatment involved subcutaneous injection. This  route of administration was based on prior pharmacokinetic (PK) studies done on laboratory cats.  Intravenous and subcutaneous routes of injection yielded similar high blood levels that were  sustained at virus inhibitory concentrations for over 24 hours. Oral administration was also found  to provide blood levels, peaking at 2 hours, but reaching only about 40% peak levels of  subcutaneous and intravenous routes (Pedersen NC, unpublished data, 2018). However, dogs  which have a longer intestinal tract evolved for omnivorous diets, can absorb up to 85% of  GS441524 by the oral route [1, 5]. Dogs have often been used as surrogates for humans in oral  absorption studies, so oral absorption in humans is also likely to be higher than in cats.

GS-441524 is administered through subcutaneous injections. It inhibits FIPV replication in naturally occurring feline infectious peritonitis infections. Treated cats begin to show visible signs of recovery within as little as 3-4 days. In addition to elimination of common clinical signs of fever, lethargy, lack of appetite and abdominal swelling, Gs-441524 has proved equally effective in eliminating neurological signs of physical paralysis. Suspected FIP cases can use GS-441524 as a diagnostic tool.

Feline infectious peritonitis (FIP) is caused by a mutant feline enteric coronavirus biotype. The resulting FIP virus (FIPV) in the case of the non-fusion form commonly causes pathologies of the central nervous system (CNS) and the eyes. More than 95% cats with FIP succumb to the disease several days to months after diagnosis, despite various historically used treatments. Recently developed antiviral drugs have shown promise in the treatment of non-neurological FIPs, but data on the treatment of neurological cases of FIP are limited. Four cases of naturally occurring FIP with CNS involvement were treated with the antiviral nucleoside analog GS-441524 (5-10 mg / kg) for at least 12 weeks. Cats were monitored continuously by physical, neurological and ophthalmological examinations. One cat underwent magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, including FCoV titer, RT-PCR, and ophthalmic examination using Fourier optical coherence tomography and in vivo confocal microscopy (IVCM). All cats responded positively to treatment. The three cats are still alive (528, 516 and 354 days after the start of treatment) with normal results of physical and neurological examinations. One cat was euthanized 216 days from the start of treatment after relapses after primary and secondary treatment. In 1 case, the cure of the disease was determined on the basis of normalization of MRI and CSF findings and examination of cranial and caudal segment disease using ocular imaging methods. Treatment with GS-441524 shows its clinical efficacy and may lead to clearance and long-term regression of neurological FIP. The doses required for CNS disease may be higher than the doses used for non-neurological FIPs.

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