February 8, 2023 • 20 mins
Description: In this episode, the hosts discuss a serious viral disease called Feline Infectious Peritonitis (FIP) that affects cats and is caused by a feline coronavirus. FIP is almost always fatal, and younger cats are at greater risk of developing it. The hosts also talk about the connection between animal health science, the drug industry, and society and how the One Health approach can help address issues related to animal and human health.
Show Notes:
- Introduction to Feline Coronavirus and Feline Infectious Peritonitis (FIP), a fatal disease that affects cats
- Discussion about the age group of cats most at risk of developing FIP (less than one and a half years old)
- A conversation about the increase in relinquished animals in shelters due to COVID-19 and misconceptions about pets transmitting COVID-19 to humans
- Personal story of the host's experience with fostering and then adopting a six-month-old cat who was later diagnosed with FIP
- Explanation of how the veterinary staff diagnosed FIP and the severity of the disease
- Discussion about the drug industry's efforts to find a cure for FIP and the challenges of developing drugs for animal diseases
- Introduction to the One Health approach and how it addresses issues related to animal and human health
- Conclusion and thanks for listening
Note: The hosts mention that the story is based on true events, but the names of people and places have been changed for privacy reasons
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniele Swetnam (00:11):
Welcome to the infectious Science Podcast. This
is not just another SciencePodcast Nope. Infectious science
is produced by a team from theUniversity of Texas Medical
Branch and the Galvestonnational
Matt Dacso (00:21):
lab where we study some of the most dangerous
viruses on the planet. Our goal
Unknown (00:25):
is to inspire future scientists towards a career in
science with a focus on onehealth, one health one planet.
That's right. One of theapproaches public health threats
by examining the connectionsbetween people, plants, animals
and the environment we allshare.
This show will explore how onehealth is your health. So sit
backand learn something infectious
science where enthusiasm forscience
(00:46):
is contagious. By now, if youare living on planet Earth, you
have heard of coronavirusesCoronavirus, has had have been
present in the animal kingdomfor a very long time and have
been on the radar ofveterinarians for many decades.
In today's episode, we are goingto talk about a Coronavirus that
only infects cats and is almostalways fatal. This isn't a new
(01:10):
disease. And don't worry, catscannot transmit this Coronavirus
to people but it can haveserious implications for Animal
Health. And here's the catch.
There may be a cure, but it isnot easy to get your hands on.
The following discussionillustrates the connection
between animal health science,the drug industry and society.
It's a clear example that helpsto define the One Health
approach. Thanks for tuning in.
(01:32):
We hope you learned something.
The following story is based ontrue events, but the names of
people in places have beenchanged.
Bente, Dennis A. (01:41):
Hey, guys, how are you doing?
Connie Holubar (01:43):
Oh, hey, yes.
Good to see you. Have you beenDanielle was just telling me the
story about you and your cat?
Bente, Dennis A. (01:51):
Yeah, the last week has been pretty rough for
me. I don't know if I told you,Connie. But you know, in the
past year, I started fosteringand recently I started fostering
a cat from the animal shelter.
They had an emergency because somany people are surrendering the
cats and dogs.
Unknown (02:07):
I've heard about this.
I've actually read about it,too. I didn't know you were
fostering but I did hear thatshelters nationwide are facing
really large numbers ofrelinquished animals really
since COVID. And they're atdesperate situations. What do
you think that is? Well, fromwhat I've read, a lot of it has
to do with the fact that peoplewent out during COVID and
adopted animals because theywere home and they had time to
(02:29):
do the training and the walkingand then everybody went back to
work and situation normal andthe victims then become the dogs
and cats and they're being takenaback. I also heard too, that
there were even people that wereconcerned that they can get
COVID from their pets. Oh, well,that's sad, because there's
really no evidence for that. Oh,yeah, I didn't know.
It is really sad. Well, I endedup fostering a fairly small six
(02:53):
month old cats use so little,and he was a tabby and as you
know, tabbies usually don't getadopted very readily. So I felt
compelled almost to adopt him.
He was so sweet. He would standon its hind legs and stretch out
and wanted to be picked up andhe wanted to snuggle with you.
He was just so affectionate andreally friendly. Oh, that
(03:15):
sounds so sweet. Yeah,I know. So when I adopted him,
or when I started fostering, Inoticed that he had a little bit
of an inflammations left eye,but it seemed that was in the
process of healing. It didn'tseem new, it seemed kind of old.
And I was wondering if it wasrelated to trauma or something
else. So I didn't pay a lot ofattention to words. I took them
(03:35):
home and actually got along withmy dog my cat very quickly.
Obviously, he was hiding underthe bed initially,
I think, yeah, you can expectcats. Yeah, you can.
But after you know, a few days,I started wondering why he was
so calm, you know, for six monthold cards. He wouldn't play with
(03:56):
them, but he would just sleepmost days.
Yeah, but I think cats sleeplike 18 hours a day, don't they?
Yes, they do. But you know, itjust didn't feel right for six
month old cards. And then all ofa sudden things change
dramatically. One day, he almosthad like what I would call a
neurological fit. Oh,that doesn't sound good. You
know, what does that mean? Well,my dog was trying to play with
(04:17):
them. And then all of a suddenhe started to salivate his
whiskers started to twitch. Andthen he was all of a sudden very
bouncy, he just jumped up anddown and just didn't look right.
It made me suspicious that hemaybe had eaten something toxic
or something else was going on.
So I actually took him to thevet the same day.
It sounds pretty serious. Yeah,yeah. So the staff was
(04:41):
super nice. And they were verybusy, but they actually took him
in immediately. They had asuspicion what it could be. And
unfortunately, the suspicioncame true very quickly after
they ran a few tests. So whatkind of tests what was it? Well,
the cat heads feline infectiousperitonitis FIP for short. Yeah,
so there's no specific test forit but you can run some other
(05:03):
tests and they are indicativethat it could be FIP and
together you know, with thetrauma in the eye or the the
inflammation in the eye, thatwas another hint that it could
be FIP so fit this very seriousviral disease in cats, and it's
caused by a feline Coronavirus,a Coronavirus, so it's like a
respiratory virus like forhumans. COVID is a respiratory
(05:26):
virus.
Well, actually, most strains ofthe virus are found in the cat's
gastrointestinal tract and don'treally cause significant
disease, but a few go on tocause FIP unfortunately, which
is really deadly disease andfatal almost all the time.
Oh my gosh, that sounds awful.
Now, Is it contagious? Can anycat get it?
(05:48):
Any kids that carries feelingCoronavirus is potentially at
risk of developing FIP. Butyounger cats are at greater risk
of developing FIP. So there werestudies that show that
approximately 70% of the casesdiagnosed in cats are less than
one and a half years of age. Andsome studies even suggest that
50% of the cases occur in catsless than seven months of age.
(06:11):
Yeah, and the most common modeof transmission for Feline
coronaviruses are believed tooccur between an infected mother
when she passes the virus alongto her kittens, usually usually
when the kittens are onlybetween five and eight weeks of
age, and the kittens that arehoused in these like high
density facilities like petshops and shelters and
categories appear to be a lotmore susceptible to FIP. And for
(06:33):
some reason, purebred cats andmale cats and geriatric cats are
also a pretty high risk, but noone really knows why.
Hmm, so these crowded shelters,that doesn't sound like a good
thing. So why do some cats endup with FIP? And others don't?
Yeah, it's a good question. Ithink it's still somewhat of an
enigma of what's going on. Butthe one of the hypotheses is
(06:57):
that these fit viruses or theCoronavirus, and the cats, they
start to mutate, and then all ofa sudden, they don't infect the
gastrointestinal tract anymore,all of a sudden, they infect
white blood cells, and thosewhite blood cells spread the
virus throughout the body. Andthe body will then mount just a
very intense inflammatoryreaction to those viruses and
(07:20):
those white blood cells, whichcauses symptoms such as fever or
weight loss, fluid accumulationin different parts of the body.
And that can even haveneurological symptoms. So FIP is
usually progressive, and it'salmost always fatal without
treatment.
Oh, no. So there's no cure. Imean, so there's treatments for
COVID but there's no cure forFIP.
(07:42):
Well, so when I was in vetschool, 20 years ago, there was
no cure. I don't know Danielle.
Um, yeah.
So I was actually I brought mynotes with me. I did some
looking into this, after youtold me and I don't know, it's
kind of this crazy story. In2018, a team at UC Davis led by
Nels Patterson published a paperdescribing a small clinical
(08:02):
trial involving 10 cats withFIP. And remember, this is a
this is a disease that is almostalways fatal. But when they
treated the cats with this drugje s 441524. I know that's a
mouthful, it's from it's from acompany called Gilead Sciences.
The results were amazing. 10 outof 10 Cats survived. And even in
(08:24):
this follow up study that theydid with 31 cats, all with fit
25 of them survived. So that'sreally, really impressive for
this disease. That's almostalways fatal.
Yeah, it is. It's pretty amazingresults.
So how does this drug work?
Well, like all Corona viruses,the viruses that cause FIP have
an RNA genome that's made up ofthese kind of like molecular
(08:45):
building blocks that we callnucleotides, you have guanine,
uracil, adenine and cytosine.
And in order to replicate thevirus steals hours actually, or
steals the cats. In this case,yes, the virus would steal the
cats. There's this reallyinteresting class of drugs
called nucleoside inhibitors.
And that's what this drug isit's a nucleoside inhibitors.
(09:06):
And they're these smallmolecules that look almost
exactly like our nucleus sides.
So much so that the virus can'ttell the difference. But when
the virus is trying to replicateitself, they make a mistake, and
they use these drugs instead ofthe nucleus sides and it kind of
jams up the virus so that it cancontinue replicating and then
(09:26):
the virus will will die. Okay,so what I'm hearing you say is,
it's kind of like if you had alock on a door, and you had a
key to that door, right? And sothe normal building blocks, you
know, you could open the doorwith the key, but this creates
something that looks just likethat lock, but the key won't
(09:47):
open the lock. And so the viruscannot replicate in that cell.
Yeah, analogy that sort ofworks. That sort of works. The
drugs. It's almost as if theywere a key that jam the lock.
It's stuck. The virus cancontinue replicating. Okay,
interesting. Well, that'sgood news.
It's actually not that simple.
It's not licensed by the FDA.
(10:07):
It's not an FDA approved drugs.
So there's no way for vets tolegally prescribe it to their
patients.
Danielle, do you know why it'snot licensed by the FDA?
Yeah, well, it's kind of thisweird story. I'm not super clear
on it. But the drug Gs 441524 isreally closely related to
another drug made by GileadSciences called Gs 5734. Another
(10:30):
mouthful, but you've probablyheard of it. It's called
remdesivir. Oh, yeah. Yeah. Soit's something we've heard of.
And in fact, in an interviewthat I read with Dr. Pettersen,
who originally did thoseclinical trials, he said in his
preliminary studies, he triedboth from Desmo beer and the
other drug Gs 441524. And theyboth worked in cat cells. In
(10:53):
their preliminary studies, heonly even chose to focus on Gs
441524 Because it was chemicallysimpler. remdesivir has
additional chemical modificationadditional phosphate group that
allows it to be taken up by thecells more easily, but it didn't
really seem to make anydifference in those early
preclinical trials and just thecat cells.
Okay, so what I know aboutremdesivir Isn't that one of the
(11:16):
drugs that FDA granted emergencyuse authorization during COVID
for the treatment of COVID.
And it's been tried for a lot ofother viruses as well, right. So
yeah,yeah, yeah, it has. So when
these papers first came out in2018, and 2019, Gilead was
originally hoping to developthis drug remdesivir as a
treatment for Ebola.
(11:38):
Unfortunately, it didn't seem tobe effective and never went on
to get any approval. And nowthey're focusing on like you
said, developing it for use inCOVID. And while some studies
have shown that there's someimpact, other studies have shown
the opposite, and shown that ithasn't been effective. But
getting back to our mainquestion here with FIP. Either
way, it's unclear if Gilead hasany interest in developing Gs
(12:01):
441524 or remdesivir. Eitherdrug for licensing and cards.
Well, that's kind ofinfuriating, considering how
fatal this disease is for cats.
Yeah,it really is. And it's this huge
hole in the veterinarycommunity.
Yeah, that's it's reallyinfuriating. I mean, there was
nothing I could do to save thethe queue, Tabby, and
(12:23):
ultimately, I had to beeuthanized.
But didn't you tell me you heardsomething about the drug maybe
was available on the blackmarket? That's kind of what sent
me a minute. Yeah, black marketfor cat drugs.
That that I took the cat toactually said that there's a
black market for for treatment.
Yeah, I actually found a paperpublished in 2021, led by
(12:43):
Samantha Evans at The Ohio StateUniversity, and she actually
surveyed members of this groupthat had gotten a hold of the
drug on the black market. Shesurveyed 393 People actually
from the group. Okay, sowhere's this drug made? If it I
mean, if it's being sold on theblack market? Where is it coming
from? It's not coming from thecompanies that created it?
(13:05):
No, no, it's actually it appearsto be coming from Chinese
companies.
How do you how do people findstuff like that on the black
market? I mean, we don't endorseanything that's really, you
know, done on the black market.
Just so clear. I personallywould never do this. Right.
Never neara veterinarians, you know, I
(13:25):
mean, that's pretty goodadvice. Yeah. Okay. So it turns
out, I did a little bit ofreading, and she has 441524,
that mouthful of a drag ispretty easy to make, you know, a
little bit about chemistry. Andapparently, there was a Chinese
company that tried to getlicensing for the drug in China,
because FIP is a problemworldwide, just like how we have
(13:47):
a lot of cats here. There's alot of cats in China, and the
company was never able to getlicensing for use in China. But
it appears they starteddeveloping it anyway, and so did
a lot of other companies. Andthat's where pretty soon pet
owners across the world foundout about this and turned to the
black market to get a hold ofthe drug. It's pretty crazy.
(14:09):
It's interesting to think about,you know, you love your pets,
and you want to help them out.
On one hand, it'sreally maddening that this drug,
if it works, isn't available.
But the other part is scary ifthe only way to get it is not
illegal. Yeah. And I mean,Gilead does own the rights of
this drug. You know, theydeveloped it, it is their drugs.
So legally, I guess they do havethe right to say who can and
(14:32):
can't develop it and license it.
And you know, I was reading thatstudy where they surveyed
members of this Facebook groupwhere you're able to get a hold
of the drug, and people paidanywhere between $521,000 for
112 week treatment. I know it'sreally expensive. And in some
cases, you know, cats haverelapses, or in cases where the
(14:54):
cats have neurological symptoms,they either have to have an A
Increase dose or a second dose,and that would bring the total
up even higher to 10,000 or$15,000.
Oh my gosh, that's so much moneyand especially for a drug that
isn't regulated, and it's beingsold peer to peer through social
media. I mean, how do you knowif it's any good? How do you
(15:17):
know if it's safe for your cat?
It sounds pretty dangerous tome.
Yeah. You can't know. Andthere's nothing really like this
before in the veterinarycommunity that I know of. I
mean, have you heard of anythinglike the status? Oh, no. So what
do you think what will happennext?
Well, there's a couple of thingsgoing on right now. So a lot of
people that I have talked to youin red, since you told me about
(15:39):
the Stennis are hoping thatremdesivir Right now, it's only
under conditional approval inthe US. But if it gets full
licensing and full FDA approval,then veterinarians can write off
label use write prescriptionsfor the drug off label. And I
think that's what they're doingright now in the UK, where the
drug is already licensed. Butyou know, it's kind of tricky,
because all the clinical trialswere done not with remdesivir.
(16:01):
But with the other drug, Gs441524. So we don't really know
how effective remdesivir is incats with FIP. So investigators
at UC Davis looks like they'velaunched another clinical trial
for cats and FIP, comparingremdesivir and the other drug,
Gs 4415 to four, and hopefullythat will lead to a more
(16:22):
reliable way for cat owners andveterinarians to treat cats with
fit. That'd be great. Becauseyou know, Dennis is little kitty
might still be alive if thisdrug was available. And it's
something we definitely want tomaybe pay attention to keep our
eye on because this is sort ofan interesting story. Yeah,
combining the black market.
Kittens and drugs manufactured.
(16:46):
Yeah, illegally, perhaps andpaying $20,000 $21,000. Yeah,
it's pretty crazy.
Yeah, you know, and when I wasin grad school, I kind of had
this feeling that if I did goodscience, I can have an important
impact. But science happens inthe real world. And there's all
these other considerations. Inaddition to science, there's the
politics and economics and thelegal things and the business
(17:10):
components to think about aswell. And then there's the human
aspect, what a person is willingto do when they have a sick
kitten or a sick family memberor something like that. This is
definitely a complicated story.
So Danielle, it sounds likeyou've done a lot of research.
down the rabbit hole. Isthere anything? Is there
anywhere where our listeners canfind more information?
Yeah, definitely. I'm gonnasummarize all my notes. And if
(17:32):
you're interested, check ourshow notes. And I'll post a full
blog with all the details. Ifyou want to check out I'll also
link the new clinical trial atUC Davis and a couple of other
articles where I foundinteresting information.
So that's great. Well, Dennis,I'm really sorry about your cat.
Yeah. Your week gets better andI hope that you know, there's
(17:53):
good news and good resolution tothis with this drug. Yeah, road
it'd bewe'll see what happens. Yeah.
Interesting. And go out and um,foster cats and dogs. Yeah. So
big needs right now. Yeah, yeah,definitely.
Rabies is a major public healthproblem worldwide. In fact,
(18:14):
there are about a 59,000 deathsper year, and that's one death
every nine minutes. Andunfortunately, 40% of those
deaths occur in children. Rabiesis usually transmitted by the
bite of an infected animal. Andglobally, the most common way to
become exposed to rabies is thebite of a dog. And in fact, 99%
of cases are from dog bitesworldwide. A big problem with
(18:38):
rabies is that it's fatal andsymptoms appear which is really
scary. And it's tragic becauserabies is 100% preventable by
vaccines. And we have reallygood vaccines available for
mammals, including humans, dogs,raccoons, etc. And as a
scientist, the thing I find mostinteresting about rabies is that
it's capable of modifying hostbehavior. So for example, in
(18:58):
herbivores are typical animalsof prey, the virus will make
them more docile and increasethe likelihood that they can
become attacked by a predator.
In the other hand, whencarnivores are infected, they
become more aggressive or rabidas they say, now you know about
rabies virus. This is your viralminute. Thanks for listening to
the infectious Science Podcast.
(19:20):
Be sure to hit subscribe andvisit infectious science.org to
join the conversation, accessthe show notes and to sign up
for our newsletter and receiveour free materials.
If you enjoyed this new episodeof infectious science, please
leave us a review on Applepodcasts at Spotify. And go
ahead and share this episodewith some of your friends.
I'll say and don't hesitate toask questions and tell us what
topics you'd like us to coverfor future episodes. To get in
(19:42):
touch, drop a line in thecomment section or send us a
message on social media.
So we'll see you next time for anew episode. And in the
meantime, stay happy stayhealthy. stay interested
Welcome to the infectious Science Podcast. This
is not just another SciencePodcast Nope. Infectious science
is produced by a team from theUniversity of Texas Medical
Branch and the Galvestonnational
Matt Dacso (00:21):
lab where we study some of the most dangerous
viruses on the planet. Our goal
Unknown (00:25):
is to inspire future scientists towards a career in
science with a focus on onehealth, one health one planet.
That's right. One of theapproaches public health threats
by examining the connectionsbetween people, plants, animals
and the environment we allshare.
This show will explore how onehealth is your health. So sit
backand learn something infectious
science where enthusiasm forscience
(00:46):
is contagious. By now, if youare living on planet Earth, you
have heard of coronavirusesCoronavirus, has had have been
present in the animal kingdomfor a very long time and have
been on the radar ofveterinarians for many decades.
In today's episode, we are goingto talk about a Coronavirus that
only infects cats and is almostalways fatal. This isn't a new
(01:10):
disease. And don't worry, catscannot transmit this Coronavirus
to people but it can haveserious implications for Animal
Health. And here's the catch.
There may be a cure, but it isnot easy to get your hands on.
The following discussionillustrates the connection
between animal health science,the drug industry and society.
It's a clear example that helpsto define the One Health
approach. Thanks for tuning in.
(01:32):
We hope you learned something.
The following story is based ontrue events, but the names of
people in places have beenchanged.
Bente, Dennis A. (01:41):
Hey, guys, how are you doing?
Connie Holubar (01:43):
Oh, hey, yes.
Good to see you. Have you beenDanielle was just telling me the
story about you and your cat?
Bente, Dennis A. (01:51):
Yeah, the last week has been pretty rough for
me. I don't know if I told you,Connie. But you know, in the
past year, I started fosteringand recently I started fostering
a cat from the animal shelter.
They had an emergency because somany people are surrendering the
cats and dogs.
Unknown (02:07):
I've heard about this.
I've actually read about it,too. I didn't know you were
fostering but I did hear thatshelters nationwide are facing
really large numbers ofrelinquished animals really
since COVID. And they're atdesperate situations. What do
you think that is? Well, fromwhat I've read, a lot of it has
to do with the fact that peoplewent out during COVID and
adopted animals because theywere home and they had time to
(02:29):
do the training and the walkingand then everybody went back to
work and situation normal andthe victims then become the dogs
and cats and they're being takenaback. I also heard too, that
there were even people that wereconcerned that they can get
COVID from their pets. Oh, well,that's sad, because there's
really no evidence for that. Oh,yeah, I didn't know.
It is really sad. Well, I endedup fostering a fairly small six
(02:53):
month old cats use so little,and he was a tabby and as you
know, tabbies usually don't getadopted very readily. So I felt
compelled almost to adopt him.
He was so sweet. He would standon its hind legs and stretch out
and wanted to be picked up andhe wanted to snuggle with you.
He was just so affectionate andreally friendly. Oh, that
(03:15):
sounds so sweet. Yeah,I know. So when I adopted him,
or when I started fostering, Inoticed that he had a little bit
of an inflammations left eye,but it seemed that was in the
process of healing. It didn'tseem new, it seemed kind of old.
And I was wondering if it wasrelated to trauma or something
else. So I didn't pay a lot ofattention to words. I took them
(03:35):
home and actually got along withmy dog my cat very quickly.
Obviously, he was hiding underthe bed initially,
I think, yeah, you can expectcats. Yeah, you can.
But after you know, a few days,I started wondering why he was
so calm, you know, for six monthold cards. He wouldn't play with
(03:56):
them, but he would just sleepmost days.
Yeah, but I think cats sleeplike 18 hours a day, don't they?
Yes, they do. But you know, itjust didn't feel right for six
month old cards. And then all ofa sudden things change
dramatically. One day, he almosthad like what I would call a
neurological fit. Oh,that doesn't sound good. You
know, what does that mean? Well,my dog was trying to play with
(04:17):
them. And then all of a suddenhe started to salivate his
whiskers started to twitch. Andthen he was all of a sudden very
bouncy, he just jumped up anddown and just didn't look right.
It made me suspicious that hemaybe had eaten something toxic
or something else was going on.
So I actually took him to thevet the same day.
It sounds pretty serious. Yeah,yeah. So the staff was
(04:41):
super nice. And they were verybusy, but they actually took him
in immediately. They had asuspicion what it could be. And
unfortunately, the suspicioncame true very quickly after
they ran a few tests. So whatkind of tests what was it? Well,
the cat heads feline infectiousperitonitis FIP for short. Yeah,
so there's no specific test forit but you can run some other
(05:03):
tests and they are indicativethat it could be FIP and
together you know, with thetrauma in the eye or the the
inflammation in the eye, thatwas another hint that it could
be FIP so fit this very seriousviral disease in cats, and it's
caused by a feline Coronavirus,a Coronavirus, so it's like a
respiratory virus like forhumans. COVID is a respiratory
(05:26):
virus.
Well, actually, most strains ofthe virus are found in the cat's
gastrointestinal tract and don'treally cause significant
disease, but a few go on tocause FIP unfortunately, which
is really deadly disease andfatal almost all the time.
Oh my gosh, that sounds awful.
Now, Is it contagious? Can anycat get it?
(05:48):
Any kids that carries feelingCoronavirus is potentially at
risk of developing FIP. Butyounger cats are at greater risk
of developing FIP. So there werestudies that show that
approximately 70% of the casesdiagnosed in cats are less than
one and a half years of age. Andsome studies even suggest that
50% of the cases occur in catsless than seven months of age.
(06:11):
Yeah, and the most common modeof transmission for Feline
coronaviruses are believed tooccur between an infected mother
when she passes the virus alongto her kittens, usually usually
when the kittens are onlybetween five and eight weeks of
age, and the kittens that arehoused in these like high
density facilities like petshops and shelters and
categories appear to be a lotmore susceptible to FIP. And for
(06:33):
some reason, purebred cats andmale cats and geriatric cats are
also a pretty high risk, but noone really knows why.
Hmm, so these crowded shelters,that doesn't sound like a good
thing. So why do some cats endup with FIP? And others don't?
Yeah, it's a good question. Ithink it's still somewhat of an
enigma of what's going on. Butthe one of the hypotheses is
(06:57):
that these fit viruses or theCoronavirus, and the cats, they
start to mutate, and then all ofa sudden, they don't infect the
gastrointestinal tract anymore,all of a sudden, they infect
white blood cells, and thosewhite blood cells spread the
virus throughout the body. Andthe body will then mount just a
very intense inflammatoryreaction to those viruses and
(07:20):
those white blood cells, whichcauses symptoms such as fever or
weight loss, fluid accumulationin different parts of the body.
And that can even haveneurological symptoms. So FIP is
usually progressive, and it'salmost always fatal without
treatment.
Oh, no. So there's no cure. Imean, so there's treatments for
COVID but there's no cure forFIP.
(07:42):
Well, so when I was in vetschool, 20 years ago, there was
no cure. I don't know Danielle.
Um, yeah.
So I was actually I brought mynotes with me. I did some
looking into this, after youtold me and I don't know, it's
kind of this crazy story. In2018, a team at UC Davis led by
Nels Patterson published a paperdescribing a small clinical
(08:02):
trial involving 10 cats withFIP. And remember, this is a
this is a disease that is almostalways fatal. But when they
treated the cats with this drugje s 441524. I know that's a
mouthful, it's from it's from acompany called Gilead Sciences.
The results were amazing. 10 outof 10 Cats survived. And even in
(08:24):
this follow up study that theydid with 31 cats, all with fit
25 of them survived. So that'sreally, really impressive for
this disease. That's almostalways fatal.
Yeah, it is. It's pretty amazingresults.
So how does this drug work?
Well, like all Corona viruses,the viruses that cause FIP have
an RNA genome that's made up ofthese kind of like molecular
(08:45):
building blocks that we callnucleotides, you have guanine,
uracil, adenine and cytosine.
And in order to replicate thevirus steals hours actually, or
steals the cats. In this case,yes, the virus would steal the
cats. There's this reallyinteresting class of drugs
called nucleoside inhibitors.
And that's what this drug isit's a nucleoside inhibitors.
(09:06):
And they're these smallmolecules that look almost
exactly like our nucleus sides.
So much so that the virus can'ttell the difference. But when
the virus is trying to replicateitself, they make a mistake, and
they use these drugs instead ofthe nucleus sides and it kind of
jams up the virus so that it cancontinue replicating and then
(09:26):
the virus will will die. Okay,so what I'm hearing you say is,
it's kind of like if you had alock on a door, and you had a
key to that door, right? And sothe normal building blocks, you
know, you could open the doorwith the key, but this creates
something that looks just likethat lock, but the key won't
(09:47):
open the lock. And so the viruscannot replicate in that cell.
Yeah, analogy that sort ofworks. That sort of works. The
drugs. It's almost as if theywere a key that jam the lock.
It's stuck. The virus cancontinue replicating. Okay,
interesting. Well, that'sgood news.
It's actually not that simple.
It's not licensed by the FDA.
(10:07):
It's not an FDA approved drugs.
So there's no way for vets tolegally prescribe it to their
patients.
Danielle, do you know why it'snot licensed by the FDA?
Yeah, well, it's kind of thisweird story. I'm not super clear
on it. But the drug Gs 441524 isreally closely related to
another drug made by GileadSciences called Gs 5734. Another
(10:30):
mouthful, but you've probablyheard of it. It's called
remdesivir. Oh, yeah. Yeah. Soit's something we've heard of.
And in fact, in an interviewthat I read with Dr. Pettersen,
who originally did thoseclinical trials, he said in his
preliminary studies, he triedboth from Desmo beer and the
other drug Gs 441524. And theyboth worked in cat cells. In
(10:53):
their preliminary studies, heonly even chose to focus on Gs
441524 Because it was chemicallysimpler. remdesivir has
additional chemical modificationadditional phosphate group that
allows it to be taken up by thecells more easily, but it didn't
really seem to make anydifference in those early
preclinical trials and just thecat cells.
Okay, so what I know aboutremdesivir Isn't that one of the
(11:16):
drugs that FDA granted emergencyuse authorization during COVID
for the treatment of COVID.
And it's been tried for a lot ofother viruses as well, right. So
yeah,yeah, yeah, it has. So when
these papers first came out in2018, and 2019, Gilead was
originally hoping to developthis drug remdesivir as a
treatment for Ebola.
(11:38):
Unfortunately, it didn't seem tobe effective and never went on
to get any approval. And nowthey're focusing on like you
said, developing it for use inCOVID. And while some studies
have shown that there's someimpact, other studies have shown
the opposite, and shown that ithasn't been effective. But
getting back to our mainquestion here with FIP. Either
way, it's unclear if Gilead hasany interest in developing Gs
(12:01):
441524 or remdesivir. Eitherdrug for licensing and cards.
Well, that's kind ofinfuriating, considering how
fatal this disease is for cats.
Yeah,it really is. And it's this huge
hole in the veterinarycommunity.
Yeah, that's it's reallyinfuriating. I mean, there was
nothing I could do to save thethe queue, Tabby, and
(12:23):
ultimately, I had to beeuthanized.
But didn't you tell me you heardsomething about the drug maybe
was available on the blackmarket? That's kind of what sent
me a minute. Yeah, black marketfor cat drugs.
That that I took the cat toactually said that there's a
black market for for treatment.
Yeah, I actually found a paperpublished in 2021, led by
(12:43):
Samantha Evans at The Ohio StateUniversity, and she actually
surveyed members of this groupthat had gotten a hold of the
drug on the black market. Shesurveyed 393 People actually
from the group. Okay, sowhere's this drug made? If it I
mean, if it's being sold on theblack market? Where is it coming
from? It's not coming from thecompanies that created it?
(13:05):
No, no, it's actually it appearsto be coming from Chinese
companies.
How do you how do people findstuff like that on the black
market? I mean, we don't endorseanything that's really, you
know, done on the black market.
Just so clear. I personallywould never do this. Right.
Never neara veterinarians, you know, I
(13:25):
mean, that's pretty goodadvice. Yeah. Okay. So it turns
out, I did a little bit ofreading, and she has 441524,
that mouthful of a drag ispretty easy to make, you know, a
little bit about chemistry. Andapparently, there was a Chinese
company that tried to getlicensing for the drug in China,
because FIP is a problemworldwide, just like how we have
(13:47):
a lot of cats here. There's alot of cats in China, and the
company was never able to getlicensing for use in China. But
it appears they starteddeveloping it anyway, and so did
a lot of other companies. Andthat's where pretty soon pet
owners across the world foundout about this and turned to the
black market to get a hold ofthe drug. It's pretty crazy.
(14:09):
It's interesting to think about,you know, you love your pets,
and you want to help them out.
On one hand, it'sreally maddening that this drug,
if it works, isn't available.
But the other part is scary ifthe only way to get it is not
illegal. Yeah. And I mean,Gilead does own the rights of
this drug. You know, theydeveloped it, it is their drugs.
So legally, I guess they do havethe right to say who can and
(14:32):
can't develop it and license it.
And you know, I was reading thatstudy where they surveyed
members of this Facebook groupwhere you're able to get a hold
of the drug, and people paidanywhere between $521,000 for
112 week treatment. I know it'sreally expensive. And in some
cases, you know, cats haverelapses, or in cases where the
(14:54):
cats have neurological symptoms,they either have to have an A
Increase dose or a second dose,and that would bring the total
up even higher to 10,000 or$15,000.
Oh my gosh, that's so much moneyand especially for a drug that
isn't regulated, and it's beingsold peer to peer through social
media. I mean, how do you knowif it's any good? How do you
(15:17):
know if it's safe for your cat?
It sounds pretty dangerous tome.
Yeah. You can't know. Andthere's nothing really like this
before in the veterinarycommunity that I know of. I
mean, have you heard of anythinglike the status? Oh, no. So what
do you think what will happennext?
Well, there's a couple of thingsgoing on right now. So a lot of
people that I have talked to youin red, since you told me about
(15:39):
the Stennis are hoping thatremdesivir Right now, it's only
under conditional approval inthe US. But if it gets full
licensing and full FDA approval,then veterinarians can write off
label use write prescriptionsfor the drug off label. And I
think that's what they're doingright now in the UK, where the
drug is already licensed. Butyou know, it's kind of tricky,
because all the clinical trialswere done not with remdesivir.
(16:01):
But with the other drug, Gs441524. So we don't really know
how effective remdesivir is incats with FIP. So investigators
at UC Davis looks like they'velaunched another clinical trial
for cats and FIP, comparingremdesivir and the other drug,
Gs 4415 to four, and hopefullythat will lead to a more
(16:22):
reliable way for cat owners andveterinarians to treat cats with
fit. That'd be great. Becauseyou know, Dennis is little kitty
might still be alive if thisdrug was available. And it's
something we definitely want tomaybe pay attention to keep our
eye on because this is sort ofan interesting story. Yeah,
combining the black market.
Kittens and drugs manufactured.
(16:46):
Yeah, illegally, perhaps andpaying $20,000 $21,000. Yeah,
it's pretty crazy.
Yeah, you know, and when I wasin grad school, I kind of had
this feeling that if I did goodscience, I can have an important
impact. But science happens inthe real world. And there's all
these other considerations. Inaddition to science, there's the
politics and economics and thelegal things and the business
(17:10):
components to think about aswell. And then there's the human
aspect, what a person is willingto do when they have a sick
kitten or a sick family memberor something like that. This is
definitely a complicated story.
So Danielle, it sounds likeyou've done a lot of research.
down the rabbit hole. Isthere anything? Is there
anywhere where our listeners canfind more information?
Yeah, definitely. I'm gonnasummarize all my notes. And if
(17:32):
you're interested, check ourshow notes. And I'll post a full
blog with all the details. Ifyou want to check out I'll also
link the new clinical trial atUC Davis and a couple of other
articles where I foundinteresting information.
So that's great. Well, Dennis,I'm really sorry about your cat.
Yeah. Your week gets better andI hope that you know, there's
(17:53):
good news and good resolution tothis with this drug. Yeah, road
it'd bewe'll see what happens. Yeah.
Interesting. And go out and um,foster cats and dogs. Yeah. So
big needs right now. Yeah, yeah,definitely.
Rabies is a major public healthproblem worldwide. In fact,
(18:14):
there are about a 59,000 deathsper year, and that's one death
every nine minutes. Andunfortunately, 40% of those
deaths occur in children. Rabiesis usually transmitted by the
bite of an infected animal. Andglobally, the most common way to
become exposed to rabies is thebite of a dog. And in fact, 99%
of cases are from dog bitesworldwide. A big problem with
(18:38):
rabies is that it's fatal andsymptoms appear which is really
scary. And it's tragic becauserabies is 100% preventable by
vaccines. And we have reallygood vaccines available for
mammals, including humans, dogs,raccoons, etc. And as a
scientist, the thing I find mostinteresting about rabies is that
it's capable of modifying hostbehavior. So for example, in
(18:58):
herbivores are typical animalsof prey, the virus will make
them more docile and increasethe likelihood that they can
become attacked by a predator.
In the other hand, whencarnivores are infected, they
become more aggressive or rabidas they say, now you know about
rabies virus. This is your viralminute. Thanks for listening to
the infectious Science Podcast.
(19:20):
Be sure to hit subscribe andvisit infectious science.org to
join the conversation, accessthe show notes and to sign up
for our newsletter and receiveour free materials.
If you enjoyed this new episodeof infectious science, please
leave us a review on Applepodcasts at Spotify. And go
ahead and share this episodewith some of your friends.
I'll say and don't hesitate toask questions and tell us what
topics you'd like us to coverfor future episodes. To get in
(19:42):
touch, drop a line in thecomment section or send us a
message on social media.
So we'll see you next time for anew episode. And in the
meantime, stay happy stayhealthy. stay interested
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