Ending FIP, Is There Hope: Winn Feline Symposium

Feline Infectious Peritonitis (FIP) is arguably the most tragic diagnosis a cat can receive. FIP mostly occurs in kittens. “They’re our innocent babies,” says Susan Gingrich, founder of the Winn Feline Foundation Bria Fund. Often, people have obtained a kitten because an older pet has passed on, and the still-grieving family now hears their baby has a fatal disease. ”Heartbreaking,” she adds.

Bria

While there are periodic reports of cats surviving FIP, they are few and far between; the disease is considered fatal.

Dr. Niels Pedersen at a Winn Feline Foundation Symposium several years ago

While there have been previous “false alarm” reports of breakthrough, this one is real. Dr. Niels Pedersen, professor emeritus at the University of California Davis School of Veterinary Medicine, will reveal the results of his most recent work on June 29 at the Winn Feline Foundation Annual Symposium at The Fairmont Chicago (200 N. Columbus Dr.).

Pedersen, the “grandfather of cat health,” recently completed Phase One of a clinical trial. The results are expected to be published in the Journal of Feline Medicine & Surgery. Using a classification of drug called a protease inhibitor (GC376 specifically), up to seven cats with FIP (of 20 total cats in the study) have gone into remission. Time will tell how long that remission will continue, but one cat, Smokey, is now about a year out.

Protease inhibitors are the same class of drug used as a part of the treatment for HIV and for Hepatitis C in people.

Pedersen says he’s “ecstatic.” And so is Gingrich, who, in 2005, launched the Bria Fund. With support from her famous brother Newt, Susan was determined to do something about the devastating disease. With an army of thousands of internet followers from around the planet, she’s lead the brigade to enhance awareness, provide real information, (there’s a lot of misinformation), and, arguably most importantly, raise money.

Susan Gingrich, Bria Fund founder

For nearly 50 years, the nonprofit Winn Feline Foundation has funded cat health studies that ultimately led to the vaccine for feline leukemia to recent support of studies for stem cell therapy.

No other organization has made such a long-standing commitment to cat health, including a laser focus to unravel the mysteries of FIP.

FIP has taken decades to fully comprehend. While Pedersen has famously been intricately involved in the description and formulation for treatments of various other infectious  diseases in cats (sometimes this work was also funded by the Winn Feline Foundation), FIP has been a tougher nut to crack.

Pedersen, who authored what was likely the first veterinary book solely dedicated to cat health, Feline Husbandry: Disease and Management in the Multiple Cat Environment, says FIP has been his worthy adversary, and he’s determined to find a solution before he fully retires. “I’m confident we’ve now opened the door at least a crack or more,” he says.

a corona virus

Here’s the 101 on FIP: The enteric feline corona virus is something that lots of cats and kittens get. It’s a highly contagious but benign virus; cats or kittens may suffer mild tummy upset or feel out of sorts for a day or two, but most often there are no symptoms, and nearly all cats or kittens recover.

For reasons still not totally clear, there’s sometimes a mutation inside the cat or kitten as the benign corona virus that transforms into life-threatening immune-mediated FIP. An inappropriate inflammatory response occurs inside the cat that may be widespread along the blood vessels (wet FIP) or it may be localized to specific tissues, such as the eye, or kidney (dry FIP). Because this antibody response is ineffective at clearing the infection, the virus continues to replicate and accumulate, as does the inflammatory response. This progresses to multi-organ failure and inevitably death.

This cat, Mr. Swanson, succumbed to FIP

Even with decades of support by Winn and other organizations, figuring out FIP hasn’t been easy. Only recently, researchers at Cornell determined the molecular code. Pedersen and others have shown there may be a genetic component, particularly among pedigreed (or purebred) cats. Pedersen’s own SOCK FIP Group funded studies to demonstrate the disease (which the veterinary community had referred to as uncommon) kills one in 100 to one in 300 of all cats under the ages of three to five years, occurring far more often among young cats living in catteries and shelters. Simply put, FIP is all too common, and devastating when you consider that, if appropriately diagnosed, the cats die.

And that is another issue. Even to this day, the dry form of FIP may be especially challenging to identify. Over the years, many cats have tragically been diagnosed with dry FIP who didn’t really have the disease, but were euthanized under the assumption that they were going to succumb to a fatal illness.

Kitten with wet FIP (effusive FIP)

Gingrich explains, “Today, a needle biopsy or a tissue sample can pick up dry FIP, or in cerebral spinal fluid to determine if the cat has dry FIP. As for wet FIP, we can now take fluid and actually find the FIP if it’s there.”

Years ago, FIP could only for certain be identified on necropsy (animal autopsy), but that is no longer the case.

The Winn Foundation is currently funding a study led by Drs. Gregg Dean and Kelly Santangelo at Colorado State University College of Veterinary Medicine and Biomedical Sciences that may result in a blood test to diagnose FIP.

Along the lines of prevention, a vaccine is often the answer, but not for FIP, Pedersen says. It’s true that there is a vaccine for FIP, but it’s about worthless. Pedersen says, “Today we know that FIP isn’t likely ever going to be vaccinatable.”

Virus-fighting drugs weren’t always considered effective, but now there are options that didn’t exist a decade or so ago. Pedersen told me in a column a few years back about his idea of using a class of anti-viral drug, and he’s done just that by collaborating with Dr. Yunjeong Kim of Kansas State University to obtain the right protease inhibitor. After first testing general safety in a test tube, Pedersen began a clinical study last year. Cats with wet FIP, particularly younger kittens, have survived with only 26 injections and minimal (if any) side effects. Of course, it’s unknown at this juncture exactly how long remission will continue.

Dr. Niels Pedersen

Unfortunately, cats with the dry from of FIP didn’t fare as well. Pedersen says that the dry form’s neurologic disease goes to the brain, and to treat that he needs a different drug, one that will penetrate the blood-brain barrier.

“Besides, a combination of drugs may be best to target the virus most effectively, in more than one way,” Pedersen says. “Now it’s a matter of punching the right drugs, which may include a Nucleoside reverse transcriptase inhibitor.”

Technical, yes. Science fiction, no. “Even recently, there’s been so much hocus pocus involving FIP,” says Pedersen. “Distraught cat owners have depended on false hope with whatever the latest miracle drug happens to be, waste their money, and most important these kitties suffer longer than they need to. This approach is new. This is based on real science and today’s technology. This is a big deal for cat lovers.”

However, there are still obstacles. For starters, Pedersen knows he has to replicate results in other cats. If he combines drugs, which drugs will he use? That could be a crapshoot, since the antivirals were developed for people and not for cats. And there’s the expense of the drugs themselves, never mind of the expenses intertwined in any scientific endeavor. And ultimately, the government will need to approve of whatever the outcome is.

“We’re so close, around the corner from doing something that pessimists said would never happen,” says Gingrich. “Still, without financial support, this isn’t going to happen anytime soon. The support must come from the deep pockets of industry as well as caring pet owners. And we can do this. Ten or twenty years from now people look back at this symposium as the turning point. And I believe 20 years from now kittens won’t be dying from FIP.”

The symposium is $35, register HERE. (The Symposium is open to all cat lovers. Veterinary professionals will receive RACE certified credit for attending. The Symposium supports the nonprofit Winn Feline Foundation).