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FIP TREATMENT INFORMATION - FOR VETERINARIANS

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BLOOD WORK SCHEDULE

Regular weight checks are a key part of treatment

  • It's very important to weigh the cat 2-3 times per week as the dose of GS is calculated taking the cat’s weight into consideration 

  • It’s a good idea to keep a log of the weights to track progress - download ours here

  • GS dose is NEVER adjusted down for weight loss - always calculate dose based on cat's HIGHEST weight since diagnosis

  • We also never lower dosage during treatment

Blood work should be performed at or around days 30, 60 and 80 of treatment

  • This is done to see how the patient is doing on the inside as well as on the outside by observing clinical improvements 

  • The first set of blood work done around day 30 may not show much if any improvement so don’t be alarmed if that’s the case 

  • The day 60 labs tell us a lot more about how treatment is progressing 

  • If results are not at desired levels by day 60, dosage might increased to help blood values reach the desired levels by day 84

  • During the 84-day observation period that follows treatment, blood work should be run every 4-6 weeks

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WEIGHING THE CAT

Avoiding all unnecessary stress is critical for an FIP kitty - please advise the below to your client

  • No new pets

  • Keep cat INDOORS whenever possible

  • No vaccines (exceptions detailed below)

  • No surgeries (except spay and neuter as per the below)

  • No big lifestyle changes if possible

MINIMIZE STRESS FOR YOUR PATIENT

There is no ONE answer regarding how to proceed with or without vaccines for an FIP kitty

  • There are many factors which can increase the cat’s risk of contracting diseases, such as where you live, whether your client has a single cat or multi-cat home, whether they foster, whether the cat is strictly indoor or not, if the cat has already had any vaccines, if the cat has other health issues, etc.

  • An FIP Warriors® veterinarian who has treated hundreds of FIP patients feels that the benefits of giving the FVRCP vaccines during treatment outweigh the risks but prefers to wait for a year after cure to give the rabies vaccine

VACCINES

  • If the cat undergoing treatment is not spayed or neutered yet, that surgery should be scheduled for between weeks 8-10 while on GS (after the 8 week blood work is reviewed)

  • If this timing for the spay or neuter is not possible, one can simply extend the GS treatment for 2 full weeks post-surgery

  • If the cat cannot be fixed during treatment, the recommendation is to wait until the observation period is over and cat is considered cured

SURGERIES

COMPOUNDED GS DOSING OVERVIEW

Compounded oral GS options state the TOTAL amount of GS in each pill or capsule

That makes the pharmacy-compunded oral protocols as follows:

  • 15mg/kg for basic Wet Abdominal FIP

  • 15mg/kg if there is pleural effusion or fluid in the chest cavity

  • 15mg/kg for Dry FIP

  • 20mg/kg for Ocular or Neurological FIP

  • If the cat is FIV positive, FeLV positive or was given a shot of Depo-Medrol, we add 5mg/kg to the dosage for each condition

Compounded injectable GS options state the amount of GS per mL in each vial

That makes the pharmacy-compunded injectable protocols as follows:

  • 8mg/kg for basic Wet Abdominal FIP

  • 8mg/kg if there is pleural effusion or fluid in the chest cavity

  • 8mg/kg for Dry FIP

  • 10mg/kg for Ocular or Neurological FIP

  • If the cat is FIV positive, FeLV positive or was given a shot of Depo-Medrol, we add 2mg/kg to the dosage for each condition

DOSING FOR COMPOUNDED ORAL GS​:

DOSING FOR COMPOUNDED INJECTABLE GS​:

  • When treating with oral GS, remove cat’s food and fast overnight (leave water available)

  • Give full dose of tablets or capsules first thing in the morning

  • Wait one hour then feed full meal

  • A small treat (such as Churu or pill pockets) can be used when giving meds

FASTING PROTOCOL FOR ORAL GS

Treatment with GS is a MINIMUM of 84 days followed by 84 days of observation

  • GS has recently become available through compounding pharmacies in the United States in both oral formulations and sterile injectables

  • What this means: ANY VETERINARIAN can prescribe GS and have the order filled in one of the participating compounding pharmacies

AVAILABILITY OF GS IN THE US

  • Dr. Niels Pedersen, retired veterinarian and professor emeritus at UC Davis is credited with discovering that GS cures FIP

  • GS and Remdesivir (which you may have heard of for treating Covid in humans) are closely related and nearly chemically identical

  • The exact dosing is determined  by type of FIP, cat weight and concentration of the GS medication

  • GS is typically administered as an injection given under the skin (sub-cu) or oral medication

GS-441524 CURES FIP

The anti-viral GS-441524, often referred to as GS, CURES 85-90% of cats properly treated with it

TREATMENT INFORMATION

NEVER DRAIN MORE THAN 30% OF TOTAL FLUID VOLUME FROM ABDOMEN

  • Draining the abdominal fluid can be risky and can cause the cat to go into shock

  • If fluid must be drained it should be no more than 30% and only if cat’s belly becomes so full that eating, bowel movements or breathing are affected

  • Chest fluid can ABSOLUTELY and MUST be drained if kitty’s breathing is labored

  • Chests fluid can be drained completely

  • Some cats may need multiple chest drains before the GS is able to prevent further accumulation of  fluid build-up

DRAINING FLUID FROM CHEST OR ABDOMEN

DO NOT GIVE AN FIP CAT DEPO-MEDROL - THEY CAN CRASH WHEN IT WEARS OFF

MANY but NOT ALL cats will benefit from a course of short-acting steroids such as Prednisolone or Dexamethasone to help stabilize the cat while the GS gets to work

  • Anti-inflammatory dosing is 1mg/kg TWICE A DAY for 5-7 days, then drop down to 1mg/kg ONCE A DAY and taper off

  • Course should be for 2 weeks maximum including tapering​​

STEROID USE DURING GS TREATMENT

GS should be given within an hour of the chosen time daily

  • If the cat is on ORAL GS and vomits within an hour of receiving the pills or capsules, a full dose should be re-administered

  • If the cat is on ORAL GS and vomits more than an hour after receiving the pills or capsules, the dose does not need to be re-administered

  • If the cat is on INJECTABLE GS and part of the dose leaks after injecting, re-administer 1/2 the total dose

  • If the cat is on INJECTABLE GS and most of the dose leaks after injecting, re-administer the full dose

  • Leaks of injectable GS should be cleaned off of the fur and skin with mild soap and water and rinsed well

ISSUES WITH ADMINISTERING GS

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