So, I was reading an article on the Veterinary Information Network(VIN). I love VIN, it’s an invaluable resource for practicing veterinarians. I was somewhat concerned when I saw an article on the front page warning vets of a new permutation of Feline Infectious Peritonitis-FIP for short. https://news.vin.com/doc/?id=11825267
FIP is a heinous scourge of cats. Unpredictable and deadly and caused by coronaviruses. See if you think this sounds familiar. Historically, coronaviruses in cats mostly causes mild disease(usually mild, self limiting diarrhea), most times not even noticed. But, in some cats, delayed reaction to the virus occurs- FIP, where the cat develops abscesses throughout the body. It is universally fatal in the long run. Most often, FIP is seen in catteries or other concentrated cat populations where shared bathroom areas spread the disease.
So, now fast forward to Cyprus, which evidently has a very large feral cat population. Incidentally, large feral cat populations, if the population density is high, are the perfect situation for FIP to develop. The development of FIP secondary to coronvirus infection is not completely understood. According to this article, it’s acting in a ‘contagious’ manner. According to VIN, “the exact mutation that leads to FIPV is unknown but may involve point deletions or mutations in the 3c gene.
The coronavirus is spread in poo and sharing litterboxes is a common source of infection. Almost all cats have been infected at some point and a small percentage become carriers. FIP itself did not seem to be contagious…..until NOW.
According to the article, “Based largely on RNA sequencing of samples from scores of FIP-positive cats, the paper authors argue that a coronavirus strain born of separate cat and dog coronaviruses may have combined to bring the fecal shedding and infectivity of regular FECV together with the virulence of a mutated FIP-causing virus in a single pathogen.” SAY WHAT????
Now, if this seems awfully coincidental, I thought the same thing. Now, out of nowhere, cat and dog corona viruses are now magically combining to create this deadly form of a usually insignificant infection? What are the chances? Seems like coronaviruses are like candy to researchers. And now a new virus in cats pops up, conveniently….oh and it even has a cutesy name to instill even more panic..FCOV-23. THE HORROR.
Now, the article is quite alarming…unless you are skeptical. I have to admit, prior to COVID, I would have been concerned. Is this a new thing? Are all my lovely cat patients going to be at risk for infection with this new monster? But I am SKEPTICAL exactly because of COVID. As I read the article, I saw the same buzzwords.
Guess how they ‘detect’ it? PCR, of course. Now, FIP is challenging because tons of cats will test positive and never develop the disease. Only a small percentage become ill and no one is really sure why. Stressed or otherwise sick cats seem to be more at risk. Sounding even more familiar? Oh, and there is a huge immune mediated pathology in these cats as well. FIP in it’s fatal form is mainly caused by the reaction to the viral infection, rather than the infection itself. I guess Corona gonna Corona, right?
So, is this all just a big to do about nothing? Did these cats reach a critical level of population that resulted in many more infections than usual? Is there some other environmental or infectious confounder? Who knows, it’s early. There is a paper in preprint if you are interested.
This is what the article said “"I think a dog came to Cyprus, pooped on the floor. A cat who already had FECV then got the dog's feces on its feet and licked its paws and had both viruses," she said. "And these viruses, that's what they do, they recombine; they're party animals. They get together, and they go, 'Oh, hey, do you want a bit of this? I'll give you a bit of that?” I shit you not. They wrote this in an article…on a Veterinary Website….like we are two year olds and don’t understand the medicine. First off….a cat would avoid dog poo like the plague…if you have a litter pan at home, and a dog, you know the converse is not true….dogs love those little tootsie rolls!! But they want us to believe that some random dog came to Cyprus and pooped where a cat would wander through it…oh and the dog was infected with a pantropic coronavirus…which, according to the most recent study I could find has a 10% infection rate in sampled deceased dogs( that were also infected with multiple other viruses at the time of death). Now, unlike dogs, cats are not really scavengers. If they didn’t kill it, they really don’t want to eat it and I doubt seriously that they would want to be anywhere a deceased or ill dog. I suppose it’s possible. The scourge of Parvovirus infection in dogs reportedly came from a jump of a feline parvovirus to canines. So, it is possible….but it’s all so….CONVENIENT.
Now, are you ready??? Here’s the kicker…..guess what they are gonna try to treat these unfortunate felines with? None other than Remdesivir and mulnupiravir….how convenient that there seems to be a bunch of that garbage laying around since COVID became a thing. The thing about cats is this, their livers are pretty incompetent when it comes to processing drugs and toxins. So medications that are often safe in dogs and humans are deadly in cats. So, let’s take a couple of real toxic drugs and throw them into cats and see what will happen? Hmmmm, I’m betting Remdesivir doesn’t fair any better in cats than it does in people….unless population control is a goal of treatment. I wonder if ANY of the researchers tried Ivermectin to treat these kitties? Cats have a very wide safety margin with Ivermectin…if they could get over iverphobia….might want to give it a shot!
Finally, what do we know really about this? Not much. The article seems a little like many of the COVID articles early on. See if this sounds familiar—-normally benign viral infection has mutated via combination of species specific corona virus strains resulting in a very highly pathogenic form. The test for detection is a PCR assay that can’t differentiate between pathogenic and nonpathogenic forms without more investigation. Oh no…..the beloved cats of Cyprus are dropping like flies.
Now read this from the colored box in the article…."First identified in the 1950s, FIP for decades was considered a death sentence. But in the past several years, antivirals — including those used to counter the coronavirus that causes Covid-19 in people, such as remdesivir, molnupiravir and Paxlovid — have been shown to reverse FIP in cats. None of these antivirals is approved for veterinary use in the United States (other than at universities studying the drugs in cats with FIP). These drugs variably are available for veterinary use in several European countries, including Cyprus, Finland, Norway, Sweden and the United Kingdom, as well as Australia and New Zealand.
In countries where treatments are not approved by regulators, pet owners have resorted to buying unlicensed antivirals produced mostly in China to treat sick cats on their own.”
Now…..if we weren’t just emerging from the COVID catastrophe….I would have read the whole article much differently. I can’t help it, but now I read this whole article with a great deal of skepticism. I hate that and love it at the same time. I used to blindly trust that VIN and other sources of information like VIN would ONLY publish things that were fully vetted(baha) and accurate. But, I also used to think that whatever the New York Times wrote was above reproach. I hate that I have lost trust in a trusted source. It’s not a total loss of trust….but the seed is there where before there was none. I HATE this….but I do love it as well. I am now much more analytical. I don’t just read the article, I research the claims and anything I don’t understand on face value. I must admit I didn’t used to do this. I took all articles at face value, secure in the knowledge that veterinary ‘experts’ wouldn’t lead me astray.
It’s Brave New World for me in veterinary medicine. I think this whole COVID thing has made me a better doctor through my skepticism. I should have been more skeptical all along, but skepticism is hard work. You have to THINK and RESEARCH. After doing such, I often come to same conclusions as the author….but not always…and then it’s really hard, because then, do I believe myself or the ‘experts?’ COVID has caused this awakening in me…..I can only hope it has had the same effect on EVERY doctor, both of humans and animals alike.
I know one thing for sure….if I diagnose an FIP cat…that would make 5 total in 25 years…I’m gonna treat that kitty with Ivermectin….just because, it won’t hurt and might help. Pretty sure NONE of the researchers will even try it because Ivermectin has been stigmatized. Oh well…..