Abstract
Feline infectious peritonitis (FIP) is a fatal disease caused by feline coronavirus or its variant, referred to as the FIP virus. Recently, favorable treatment outcomes of the anti-viral drug Mutian® Xraphconn (Mutian X) were noted in cats with FIP. Thus, the therapeutic efficacy of Mutian X in cats with FIP must be explored, although the predictors of therapeutic success remain unknown. In the present study, we administered Mutian X to 141 pet cats with effusive FIP following initial veterinarian examinations. Of these, 116 cats survived but the remaining 25 died during treatment. Pre-treatment signalment, viral gene expression, and representative laboratory parameters for routine FIP diagnosis (i.e., hematocrit, albumin-to-globulin ratio, total bilirubin, serum amyloid-A, and α1-acid glycoprotein) were statistically compared between the survivor and non-survivor groups. The majority of these parameters, including hematocrit, albumin-to-globulin ratio, serum amyloid-A, α1-acid glycoprotein, and viral gene expression, were comparable between the two groups. Interestingly, however, total bilirubin levels in the survivor group were significantly lower than those in the non-survivor group (p < 0.0001). Furthermore, in almost all surviving cats with effusive FIP (96.6%, 28/29), the pre-treatment total bilirubin levels were below 0.5 mg/dL; however, the survival rate decreased drastically (14.3%, 1/7) when the pre-treatment total bilirubin levels exceeded 4.0 mg/dL. Thus, circulating total bilirubin levels may act as a prognostic risk factor for severe FIP and may serve as the predictor of the therapeutic efficacy of Mutian X against this fatal disease.
Highlights
Feline infectious peritonitis (FIP) is a fatal disease caused by a variant of feline coronavirus, referred to as the FIP virus (FIPV) [1,2,3]
The antemortem diagnosis of FIP is difficult, and no non-invasive confirmatory test is available to diagnose any type of FIP, effusive or not; diagnosis can be made with reasonable certainty based on the results of physical examination, clinicopathological tests, antibody titers for feline coronavirus, and viral gene expression analysis using polymerase chain reaction (PCR) of biological specimens, including blood, ascites, or pleural effusions [4,5]
In the present study, we describe our experience of drastic symptomatic improvement and apparent life prolongation following the administration of a novel adenosine nucleoside analog to cats with effusive FIP
Summary
Feline infectious peritonitis (FIP) is a fatal disease caused by a variant of feline coronavirus, referred to as the FIP virus (FIPV) [1,2,3]. The effusive type of the disease is characterized by the accumulation of ascites or pleural fluid, while the non-effusive type is characterized by the granulomatous involvement of several organs, central nervous system symptoms, or ocular manifestations; the mixed type is characterized by all these [1,4]. The antemortem diagnosis of FIP is difficult, and no non-invasive confirmatory test is available to diagnose any type of FIP, effusive or not; diagnosis can be made with reasonable certainty based on the results of physical examination, clinicopathological tests, antibody titers for feline coronavirus, and viral gene expression analysis using polymerase chain reaction (PCR) of biological specimens, including blood, ascites, or pleural effusions [4,5]. Given the lack of investigations on prophylactic agents, avoiding group hoarding or reducing stress of the affected cats remains the residual measure to relieve symptoms [1,4,5,6]
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