Breakthrough FIP Drug: Save Your Cat!

Vetsplanation presents a special episode on the new FIP drug that's making waves in the veterinary world. Dr. Sugerman explains how GS-441524, now accessible via the grey market within a complex legal battle, is providing new hope for cats with Feline Infectious Peritonitis. Tune in to learn about the drug's promising clinical trial results, its grey market status, and its impact on feline health. And don’t miss our bonus segment on the surprising world of snails! 

In this episode you will learn:

• The latest breakthrough in feline medicine: GS-441524 for FIP
• How GS-441524 works to treat Feline Infectious Peritonitis
• The difference between the wet and dry forms of FIP
• Legal status and grey market availability of GS-441524
• Clinical trial results and survival rates for FIP-treated cats
• Potential impact and future research inspired by GS-441524
• Importance of discussing new treatment options with veterinarians.
• Fascinating facts about snails, including their unique traits and behaviors

Transcript

Dr. Sugerman: 0:00

Today we're diving into an exciting development in the world of feline medicine. The new FIP drug is set to be released in June. So actually we have talked about this before. We've talked about how there was an FIP drug that has been used but is illegal for us to prescribe on the black market. So have you ever even thought about buying a drug off the black market for your cat? We'll review FIP real quick, and if you stay till the end, we'll talk about some crazy facts about snails. Did you know that snails have teeth? Like, how many teeth do you think a snail has? You'll be surprised when you find out. I'm Dr. Sugerman, and welcome to Vetsplanation, where we break down the latest in veterinary medicine for pet parents and enthusiasts alike. So let's jump into FIP. All right, to start, let's briefly review what FIP is. FIP, or feline infectious peritonitis, is a viral disease caused by a strain of feline coronavirus. So while cats might carry feline coronavirus without showing symptoms, a mutation in the virus can lead to FIP, which, if left untreated, is almost always fatal. If this is all news to you, you can definitely go back to our FIP episode where I discuss all of this in more detail. People always think that the mutation has to happen when they're a baby, but actually the most common time for this to occur is around two years old. So to give you a better picture, if you had, let's say, four yellow flowers, all identical when they come up, and I infect them all with a virus that causes them to have some sort of change. But you don't really see anything different with those flowers. But then maybe three weeks later, one of those flowers changes to a blue color, wilts away, and dies. They were all infected with the same disease. But only one of those viruses mutated to cause this flower to die. It changed what that virus was in order to cause a worsening illness. Alright, back to cats since I don't treat flowers. There are two main forms of FIP. So the wet, effusive form and the dry, non effusive form. The wet form causes fluid to accumulate in places like the abdomen or the chest. While the dry form leads to the formation of things called granulomas or basically like really thick abscesses. The dry form can affect the neurological system so the brain or even the kidneys and even the eyes. Both forms are severe and really challenging to treat. Now, I know we all hated COVID, but there was something that was really cool that came out of the pandemic. There was this drug called Remdesivir, that was used to treat COVID patients, which is a coronavirus, just like in cats. So remember the coronavirus mutates to FIP, but now there's a glimmer of hope on the horizon. This June, a groundbreaking drug for FIP is going to be set to be released. This drug, which is very similar to that Remdesivir. Named GS-441524, and hopefully they get a better name for this, has shown remarkable efficacy in clinical trials. So this GS-441524 works by inhibiting the replication or stopping the replication of the virus within the cat's body, so it stops that virus from making more viruses. In studies, it is not only shown to have improved survival rates, but also reduced the symptoms significantly. For many cats diagnosed with FIP, this could mean a much better prognosis and better quality of life. So let's talk about these clinical trials. The trials for GS-441524 included a diverse group of cats with both wet and dry forms of FIP. Dr. Černá talked to us a little bit about some of the study that she had been doing as well, which included those both wet and dry forms too. Hers was a bit different than these studies, but definitely they had some very similar outcomes. So the results indicated that a survival rate of over 80 percent for the wet form, or effusive FIP, and a bit lower, unfortunately, for the dry FIP, which is unprecedented for this disease. That means that we went from almost 100 percent of our FIP patients dying to about 80ish percent living. That is huge. So before this drug, our treatment options were really limited. We largely did palliative care, focusing on symptom management rather than actually a cure. Then this drug, started to be researched. Now with GS-441524, we have a targeted antiviral treatment that addresses the root of the problem, or the root cause of this disease. The problem was though that you could only legally get it if you were doing a research trial, or you would have to go on to the black market to obtain this in order to save your cat's life. So there was a rumor that was put out that GS-441524 will be legal as of June 1st. That is actually not true. So the FDA or the Food Drug Administration, who's in charge of all the medications we prescribed, has stated that if a veterinarian chooses to prescribe this medication, that they just will not take an enforcement action. Why does the FDA care, you might ask? And why don't they just approve this medication? This medication is a compounded medication or basically it's made from a bulk medication where they take small amounts from a more potent larger medication, which is not something that's approved by the FDA and in fact is actually illegal, which means that legally we cannot prescribe it. And instead, we would just nudge parents to be like, Hey, pet parent, there's this really cool way that you could find this drug to be able to save your cat. We would just nudge them to where they could find it. But we legally could not prescribe it, nor could we get it for them. So, GS-441524 is not a legal drug. But we can prescribe it now, so it's more like what we call a gray market drug instead of a black market drug. We're not going to get in trouble for prescribing it, but it's technically not legal to prescribe it. So the FDA put out a statement that says that we can use it because under Section GFI 256, Under certain conditions, the FDA can elect not to enforce actions for compounded products for use in animals. Which is what we are saying with this drug. They're not saying it's going to be legal, but they're saying that they're not going to enforce any regulations on it. So for pet parents, this means hope, essentially. If your cat is diagnosed with FIP, there is now a viable treatment option that can offer a real chance at recovery for these cats. However, it is important to note that this drug is likely going to be expensive because it might not be immediately available in all regions. Availability and cost are always concerns with these new treatments. It is really crucial for cat parents to discuss this option with their veterinarian so that you can best understand what the best course of action is for your pet. So looking ahead, the release of GS-441524 is a significant milestone in veterinary medicine. It also opens the door for further research into antiviral treatments for lots of other types of diseases. This could just be the beginning. The success of GS-441524 might inspire more investment and more research into treatments for other viral diseases in cats or even other animals. It's already inspired, like Dr. Černá, to do more research in using two drugs together, which is fantastic. So in conclusion, the new FIP drug represents a major advancement in our feline health care. It's a reminder of the importance of the ongoing research and development in veterinary medicine. So we look forward to seeing the positive impacts this drug is going to have on the lives of all of our cats and for our pet parents. So if you have made it this far, thank you and hit that subscribe button or leave us a five star review. And always please make sure to tell somebody else about our podcast. We love when people talk about how much knowledge they've gained from us. Let's take a minute and we're going to talk about snails that I promised you. So snails are actually super interesting. People don't realize that. Everyone knows that snails make mucus, right? And that's the little mucus trail that they leave. But, they use that to help them do a couple of things. One is to help them move. They're not very good at movement. Actually their movement is just one little foot, right? That just kind of like, squishes and then moves, and squishes and moves. And that's really, that takes a lot of energy, unfortunately. So they leave that trail because that helps them to be able to move a little bit faster. It also helps them stick to things. So stick to things like walls, right? They can use their foot as a suction cup and move up the wall. The Costa Rican land snail, which I bet you didn't know there was multiple snails, huh? Costa Rican land snail uses this mucus to help invert itself under a leaf. So it's able to hide from the hot Sun. It's gotta hang upside down in order to be able to... to hold on with this slime that it produces. Did you know that they also produce this mucus to help protect them from sharp objects? So it just helps them glide over it and not like slice open their foot to their vital organs. So since they use this mucus for movement with one foot, essentially, like I said. Their movement is really slow, which we already know about snails, right? Slow as a snail. So if all of these snails are slow, how are they able to find a mate and reproduce so quickly then? What if two males meet in the wild? How long did it take them to get to that location in the first place? And then you have two males meet and you're like, ah, shoot, I can't mate now, right? A lot of them are actually hermaphrodites. So when two males meet, they can both technically inseminate each other, and they can both produce eggs. So then they produce about a hundred eggs that they wrap in this really viscous goo, in a wet area to help protect them. So only a small percentage of'em are actually gonna survive though due to the rain washing them away and predators eating them. Since no one's really watching over them, they're really just protecting'em as goo. So when they hatch, they actually look like they have a see through body that changes to a bluish color and then a brown color. And then it will, after that, develop any markings that are typical for that breed of snail, which there are so many of them. All right, did you come up with a guess now on how many teeth that they have? So their teeth are actually called radula and they're located on the tongue. They have about 120 rows of 100 teeth. So most snails have about 12,000 teeth. And in some species, they have about 20,000 teeth. They use these to scrape and cut all those leaves. Seems like a really large amount of teeth just for plants, right? But that's what they need to be able to use. Lastly, let's talk about their lifespan. Most snails live to be about two to five years old, which I thought was just crazy. When kept in captivity, they can even live longer than that, about 10 to 15 years on average, or even longer. I just always assumed that they were very fast hatching and then fast to die unfortunately of some sort of circumstance. From a bird eating them and stuff, but they can live for a long time in the wild. All right, thanks for joining me on this episode of Vetsplanation. If you have any questions or topics you'd like me to cover, please reach out to us on our social media or on our website. I hope this demystifies the new FIP drug for you, and that you've also learned something new about snails and how they're actually really interesting. Until next time. Please keep your pets happy healthy and safe. Thanks guys. We'll see you next week