Clinical Assistant Professor University of Wisconsin-Madison School of Veterinary Medicine Madison, WI, United States
Abstract:
Background: Feline infectious peritonitis (FIP) is a fatal disease of cats caused by feline coronavirus; until recent years there was no effective treatment. However, the recently developed antiviral drug remdesivir can reverse the clinical progression of FIP and lead to long term remission. Since remdesivir was approved by the FDA in April 2022 it is available legally to veterinarians for off-label use in cats.
Objectives: To describe treatment protocols and outcomes of 5 cats with FIP treated in-hospital with an initial course of injectable remdesivir (Veklury®).Animals: 5 cats.
Methods: Descriptive case series.
Results: 5 cats were treated for FIP with remdesivir between 2/2023-12/2023. Remdesivir was administered at doses between 10-22 mg/kg via intravenous continuous rate infusion over 1-8 hours, repeated every 12-24 hours for 1-4 days. No adverse effects were noted during administration. Following initial remdesivir treatment, all five cats were reported by owners to have received additional at-home treatment with unlicensed crowd-soured supplements marketed as GS-441524. At the time of writing, 3/5 cats have completed treatment (treatment duration 84-114 days) and remain in remission with complete response off antiviral medications; 2/5 cats remain in treatment at-home (treatment duration at time of writing 37 and 42 days) both with partial response.Conclusions and clinical importanceInitial treatment of FIP with IV remdesivir (Veklury®) was feasible and effective in these cats. Future research should investigate whether initial IV remdesivir treatment improves survival or hastens recovery in critically ill cats with FIP compared to current practice using unlicensed GS-like supplements alone.
