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Taylor SS, Coggins S, Barker EN, Gunn-Moore D, Jeevaratnam K, Norris JM, Hughes D, Stacey E, MacFarlane L, O'Brien C, Korman R, McLauchlan G, Salord Torres X, Taylor A, Bongers J, Espada Castro L, Foreman M, McMurrough J, Thomas B, Royaux E, Calvo Saiz I, Bertoldi G, Harlos C, Work M, Prior C, Sorrell S, Malik R, Tasker S. Retrospective study and outcome of 307 cats with feline infectious peritonitis treated with legally sourced veterinary compounded preparations of remdesivir and GS-441524 (2020-2022). J Feline Med Surg 2023; 25:1098612X231194460. [PMID: 37732386 PMCID: PMC10812036 DOI: 10.1177/1098612x231194460] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVES Feline infectious peritonitis (FIP) is a serious disease that arises due to feline coronavirus infection. The nucleoside analogues remdesivir and GS-441524 can be effective in its treatment, but most studies have used unregulated products of unknown composition. The aim of the present study was to describe the treatment of FIP using legally sourced veterinary-prescribed regulated veterinary compounded products containing known amounts of remdesivir (injectable) or GS-441524 (oral tablets). METHODS Cats were recruited via email advice services, product sales contacts and study publicity. Cats were excluded if they were deemed unlikely to have FIP, were not treated exclusively with the veterinary compounded products, or if there was a lack of cat and/or treatment (including response) data. Extensive cat and treatment data were collected. RESULTS Among the 307 cats recruited, the predominant type of FIP was most commonly abdominal effusive (49.5%) and then neurological (14.3%). Three treatment protocols were used; remdesivir alone (33.9%), remdesivir followed by GS-441524 (55.7%) and GS-441524 alone (10.4%). The median (range) initial treatment period duration and longest follow-up time point after starting treatment were 84 (1-330) days and 248 (1-814) days, respectively. The most common side effect was injection pain (in 47.8% of those given subcutaneous remdesivir). Of the 307 cats, 33 (10.8%) relapsed, 15 (45.5%) during and 18 (54.5%) after the initial treatment period. At the longest follow-up time point after completion of the initial treatment period, 84.4% of cats were alive. The cats achieving a complete response within 30 days of starting treatment were significantly more likely to be alive at the end of the initial treatment period than those cats that did not. CONCLUSIONS AND RELEVANCE Legally sourced remdesivir and GS-441524 products, either alone or used sequentially, were very effective in the treatment of FIP in this group of cats. Variable protocols precluded statistical comparison of treatment regimens.
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Affiliation(s)
- Samantha S Taylor
- International Society of Feline Medicine, Tisbury, UK
- Linnaeus Veterinary Limited, Shirley, UK
- University of Surrey, Guildford, UK
| | | | - Emi N Barker
- Langford Vets, University of Bristol, Langford, UK
- Bristol Veterinary School, University of Bristol, Langford, UK
| | | | | | | | - David Hughes
- Concord Veterinary Hospital, Sydney, NSW, Australia
| | | | | | | | | | | | | | - Aimee Taylor
- Langford Vets, University of Bristol, Langford, UK
| | | | | | | | | | | | | | | | | | | | - Megan Work
- Willows Veterinary Centre and Referral Service, Shirley, UK
| | - Cameron Prior
- Willows Veterinary Centre and Referral Service, Shirley, UK
| | | | | | - Séverine Tasker
- Linnaeus Veterinary Limited, Shirley, UK
- Bristol Veterinary School, University of Bristol, Langford, UK
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Tasker S, Addie DD, Egberink H, Hofmann-Lehmann R, Hosie MJ, Truyen U, Belák S, Boucraut-Baralon C, Frymus T, Lloret A, Marsilio F, Pennisi MG, Thiry E, Möstl K, Hartmann K. Feline Infectious Peritonitis: European Advisory Board on Cat Diseases Guidelines. Viruses 2023; 15:1847. [PMID: 37766254 PMCID: PMC10535984 DOI: 10.3390/v15091847] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Feline coronavirus (FCoV) is a ubiquitous RNA virus of cats, which is transmitted faeco-orally. In these guidelines, the European Advisory Board on Cat Diseases (ABCD) presents a comprehensive review of feline infectious peritonitis (FIP). FCoV is primarily an enteric virus and most infections do not cause clinical signs, or result in only enteritis, but a small proportion of FCoV-infected cats develop FIP. The pathology in FIP comprises a perivascular phlebitis that can affect any organ. Cats under two years old are most frequently affected by FIP. Most cats present with fever, anorexia, and weight loss; many have effusions, and some have ocular and/or neurological signs. Making a diagnosis is complex and ABCD FIP Diagnostic Approach Tools are available to aid veterinarians. Sampling an effusion, when present, for cytology, biochemistry, and FCoV RNA or FCoV antigen detection is very useful diagnostically. In the absence of an effusion, fine-needle aspirates from affected organs for cytology and FCoV RNA or FCoV antigen detection are helpful. Definitive diagnosis usually requires histopathology with FCoV antigen detection. Antiviral treatments now enable recovery in many cases from this previously fatal disease; nucleoside analogues (e.g., oral GS-441524) are very effective, although they are not available in all countries.
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Affiliation(s)
- Séverine Tasker
- Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, UK
- Linnaeus Veterinary Limited, Shirley, Solihull B90 4BN, UK
| | - Diane D. Addie
- Independent Researcher, 64000 Pyrénées Aquitaine, France;
| | - Herman Egberink
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, University of Utrecht, 3584 CL Utrecht, The Netherlands;
| | - Regina Hofmann-Lehmann
- Clinical Laboratory, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland;
| | - Margaret J. Hosie
- MRC-University of Glasgow Centre for Virus Research, Garscube Estate, Glasgow G61 1QH, UK;
| | - Uwe Truyen
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, 04103 Leipzig, Germany;
| | - Sándor Belák
- Department of Biomedical Sciences and Veterinary Public Health (BVF), Swedish University of Agricultural Sciences (SLU), P.O. Box 7036, 750 07 Uppsala, Sweden;
| | | | - Tadeusz Frymus
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, 02-787 Warsaw, Poland;
| | - Albert Lloret
- Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain;
| | - Fulvio Marsilio
- Faculty of Veterinary Medicine, Università Degli Studi di Teramo, 64100 Teramo, Italy;
| | - Maria Grazia Pennisi
- Dipartimento di Scienze Veterinarie, Università di Messina, 98168 Messina, Italy;
| | - Etienne Thiry
- Veterinary Virology and Animal Viral Diseases, Department of Infectious and Parasitic Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, B-4000 Liège, Belgium;
| | - Karin Möstl
- Institute of Virology, Department for Pathobiology, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Katrin Hartmann
- LMU Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, 80539 Munich, Germany;
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Hobi S, Beatty JA, Sandy JR, Barrs VR. Successful management of feline pemphigus foliaceus with pentoxifylline and topical hydrocortisone aceponate. Vet Med Sci 2022; 8:937-944. [PMID: 35212177 PMCID: PMC9122467 DOI: 10.1002/vms3.768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The treatment regimen for feline pemphigus foliaceus (PF), an autoimmune disease caused by auto-antibodies against proteins of the desmosome junction, usually includes high doses of oral or parenteral immunosuppressive drugs, typically glucocorticoids. This case adds to a growing body of evidence that topical hydrocortisone aceponate is effective for the treatment of feline PF, and demonstrates the practical use of a non-invasive diagnostic method for histopathology when owners refuse a biopsy to support a clinical diagnosis of PF. Finally, this case highlights an international trend of owner-initiated treatment of feline infectious peritonitis (FIP) using unlicensed, unregistered drugs.
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Affiliation(s)
- Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Kowloon, Hong Kong, China
| | - Julia A Beatty
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Kowloon, Hong Kong, China
| | - Jeanine R Sandy
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Kowloon, Hong Kong, China
| | - Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Kowloon, Hong Kong, China
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