Hope is Rising in the Fight Against FIP

by Steve Dale

Feline Infectious Peritonitis (FIP) has been a diagnosis without hope. Until now. A new medication shows promise, and a cutting-edge genetic breakthrough may be near.

Once clinical signs occurred, FIP had been considered fatal. This is heartbreaking because most instances of FIP occur in kittens -- and as many as one to 10 of 100 kitties dies of the disease.

Since 1963, when FIP was first discovered, there had been little real progress. At one point, researchers were so stymied, many gave up.

Dr. Niels Pedersen, of the University of California-Davis, is a legendary veterinarian who contributed significantly to what veterinarians know today about nearly every infectious disease in cats.

"FIP is the most complicated disease I have personally studied -- you name it, I studied it," Pedersen told a crowd of nearly 200 veterinarians, cat breeders and cat lovers at the 33rd Annual Winn Foundation Symposium June 23 in Reston, VA. "FIP is the first disease I studied, and it will be the last; I told myself that I will not retire until I find some sort of solution for this disease." His statement met with thunderous applause.

I had the honor of emceeing the symposium. I pointed out that if a disease like FIP occurred in dogs, somehow enough money would have been raised to find a cure. Again, the crowd cheered. Feline fans in the audience knew that for whatever reason, it's far more challenging to raise funds to help kittens than puppies.

Thankfully, there was plenty of good news; perhaps more significant news about FIP was reported during the 3-hour symposium than over the past decade.

Dr. Al Legendre, of the University of Tennessee College of Veterinary Medicine, Knoxville, also spoke, and like Pedersen, Legendre is considered a rock star among veterinarians, and determined to do what it takes to "help the poor kittens" with FIP.

Legendre explained how a drug called Polyprenyl Immunostimulant (PI) -- originally targeted to help cats with feline herpes virus (rhinotracheitis) -- has been studied to treat cats with one type of FIP (dry, or non-effusive FIP). The Winn Feline Foundation funded a trial, which initially included 102 cats, starting in early 2010. At present, median survival on PI is 49 days, but that number increases daily since many cats in the study are still alive and seemingly well.

Typically, cats diagnosed with dry FIP live for months or sometimes years, so there's no way to know how these cats might have faired without the PI treatment. Still, there's lots of room for optimism. For starters, many cats in the trial who were doing poorly, are not only still alive but nearly or completely symptom-free. One poster cat is five years out from an earlier study. Typically, cats with dry FIP rarely survive five years.

Still, PI does not help cats with the other type of FIP (effusive, or wet FIP). And not all cats with dry FIP thrive after receiving PI. Some who do thrive then "crash and burn."

"We don't know why that happens," says Legendre. "Just when their owners think they're over it, some deteriorate very rapidly. But even then we presumably extend their lives and improve their quality of life." Legendre wondered out loud if perhaps the final answer is using PI in combination with a yet-to-be determined anti-viral drug.

Pedersen agreed. "We have all these anti-viral drugs originally created for potentially treating HIV or hepatitis (in people) sitting in repositories. From these drugs, you may find an effective drug (to treat FIP)." But the cost of such an undertaking could be prohibitive.

While Legendre is focusing on a drug therapy, Pedersen is targeting a genetic solution to FIP.

"We now understand that far more cats are likely infected with the feline infectious peritonitis virus than ultimately die," he revealed. "Yet, the disease is fatal." So what's going on? Pedersen explained that about 20 percent of cats infected with a benign corona virus suffer a mutation, which transforms that benign virus into the potentially fatal virus. However, only two to five percent of those cats actually get sick, ultimately dying of FIP.

"Presumably the remaining 15 to18 percent manage to mount an effective immune response to the virus," he said. Pedersen wants to know what's in those cats' genetic make up that makes it possible for them to fight off the disease. He points to stress as another factor, as is the amount of active virus being shed, and the overall health of the kittens.

Pedersen hopes to identify genetic markers for a greater susceptibility to FIP and perhaps markers indicating a resistance to the disease. He has asked for breeders to help by sending cheek swabs (saliva on a Q-tip) to his lab from cats diagnosed with FIP, or cats who have close relatives with FIP.

"We can do something here," said Pedersen, who's raising awareness and money at www.sockfip.info. However, overall, breeders have not responded. One supportive breeder at the symposium shouted, "FIP has to come out of the closet."

Also announced at the symposium, PI is expected to be available to veterinarians within the next several months, with an initial label for feline herpes virus.

Learn more at www.winnfelinehealth.org, where an audio podcast of the symposium will soon be available at no charge.

(In full disclosure, Steve Dale is a member of the board of directors of the non-profit Winn Feline Foundation. Its mission is to raise funds for cat health studies.)

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