May 31, 2024 • 12 mins
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
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Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Sugerman (00:00):
Today we're diving into an exciting development in
the world of feline medicine.
The new FIP drug is set to bereleased in June.
So actually we have talked aboutthis before.
We've talked about how there wasan FIP drug that has been used
but is illegal for us toprescribe on the black market.
So have you ever even thoughtabout buying a drug off the
(00:20):
black market for your cat?
We'll review FIP real quick, andif you stay till the end, we'll
talk about some crazy factsabout snails.
Did you know that snails haveteeth?
Like, how many teeth do youthink a snail has?
You'll be surprised when youfind out.
I'm Dr.
Sugerman, and welcome toVetsplanation, where we break
down the latest in veterinarymedicine for pet parents and
(00:41):
enthusiasts alike.
So let's jump into FIP.
All right, to start, let'sbriefly review what FIP is.
FIP, or feline infectiousperitonitis, is a viral disease
caused by a strain of felinecoronavirus.
So while cats might carry felinecoronavirus without showing
symptoms, a mutation in thevirus can lead to FIP, which, if
(01:06):
left untreated, is almost alwaysfatal.
If this is all news to you, youcan definitely go back to our
FIP episode where I discuss allof this in more detail.
People always think that themutation has to happen when
they're a baby, but actually themost 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
(01:28):
yellow flowers, all identicalwhen they come up, and I infect
them all with a virus thatcauses them to have some sort of
change.
But you don't really seeanything different with those
flowers.
But then maybe three weekslater, one of those flowers
changes to a blue color, wiltsaway, and dies.
They were all infected with thesame disease.
But only one of those virusesmutated to cause this flower to
(01:52):
die.
It changed what that virus wasin order to cause a worsening
illness.
Alright, back to cats since Idon't treat flowers.
There are two main forms of FIP.
So the wet, effusive form andthe dry, non effusive form.
The wet form causes fluid toaccumulate in places like the
(02:13):
abdomen or the chest.
While the dry form leads to theformation of things called
granulomas or basically likereally thick abscesses.
The dry form can affect theneurological system so the brain
or even the kidneys and even theeyes.
Both forms are severe and reallychallenging to treat.
(02:34):
Now, I know we all hated COVID,but there was something that was
really cool that came out of thepandemic.
There was this drug calledRemdesivir, that was used to
treat COVID patients, which is acoronavirus, just like in cats.
So remember the coronavirusmutates to FIP, but now there's
a glimmer of hope on thehorizon.
(02:55):
This June, a groundbreaking drugfor FIP is going to be set to be
released.
This drug, which is very similarto that Remdesivir.
Named GS-441524, and hopefullythey get a better name for this,
has shown remarkable efficacy inclinical trials.
So this GS-441524 works byinhibiting the replication or
(03:19):
stopping the replication of thevirus within the cat's body, so
it stops that virus from makingmore viruses.
In studies, it is not only shownto have improved survival rates,
but also reduced the symptomssignificantly.
For many cats diagnosed withFIP, this could mean a much
better prognosis and betterquality of life.
(03:41):
So let's talk about theseclinical trials.
The trials for GS-441524included a diverse group of cats
with both wet and dry forms ofFIP.
Dr.
Černá talked to us a little bitabout some of the study that she
had been doing as well, whichincluded those both wet and dry
forms too.
(04:02):
Hers was a bit different thanthese studies, but definitely
they had some very similaroutcomes.
So the results indicated that asurvival rate of over 80 percent
for the wet form, or effusiveFIP, and a bit lower,
unfortunately, for the dry FIP,which is unprecedented for this
disease.
That means that we went fromalmost 100 percent of our FIP
(04:23):
patients dying to about 80ishpercent living.
That is huge.
So before this drug, ourtreatment options were really
limited.
We largely did palliative care,focusing on symptom management
rather than actually a cure.
Then this drug, started to beresearched.
Now with GS-441524, we have atargeted antiviral treatment
(04:46):
that addresses the root of theproblem, or the root cause of
this disease.
The problem was though that youcould only legally get it if you
were doing a research trial, oryou would have to go on to the
black market to obtain this inorder to save your cat's life.
So there was a rumor that wasput out that GS-441524 will be
(05:09):
legal as of June 1st.
That is actually not true.
So the FDA or the Food DrugAdministration, who's in charge
of all the medications weprescribed, has stated that if a
veterinarian chooses toprescribe this medication, that
they just will not take anenforcement action.
Why does the FDA care, you mightask?
(05:31):
And why don't they just approvethis medication?
This medication is a compoundedmedication or basically it's
made from a bulk medicationwhere they take small amounts
from a more potent largermedication, which is not
something that's approved by theFDA and in fact is actually
illegal, which means thatlegally we cannot prescribe it.
(05:52):
And instead, we would just nudgeparents to be like, Hey, pet
parent, there's this really coolway that you could find this
drug to be able to save yourcat.
We would just nudge them towhere they could find it.
But we legally could notprescribe it, nor could we get
it for them.
So, GS-441524 is not a legaldrug.
But we can prescribe it now, soit's more like what we call a
(06:16):
gray market drug instead of ablack market drug.
We're not going to get introuble for prescribing it, but
it's technically not legal toprescribe it.
So the FDA put out a statementthat says that we can use it
because under Section GFI 256,Under certain conditions, the
FDA can elect not to enforceactions for compounded products
(06:39):
for use in animals.
Which is what we are saying withthis drug.
They're not saying it's going tobe legal, but they're saying
that they're not going toenforce any regulations on it.
So for pet parents, this meanshope, essentially.
If your cat is diagnosed withFIP, there is now a viable
treatment option that can offera real chance at recovery for
(07:01):
these cats.
However, it is important to notethat this drug is likely going
to be expensive because it mightnot be immediately available in
all regions.
Availability and cost are alwaysconcerns with these new
treatments.
It is really crucial for catparents to discuss this option
with their veterinarian so thatyou can best understand what the
best course of action is foryour pet.
(07:24):
So looking ahead, the release ofGS-441524 is a significant
milestone in veterinarymedicine.
It also opens the door forfurther research into antiviral
treatments for lots of othertypes of diseases.
This could just be thebeginning.
The success of GS-441524 mightinspire more investment and more
(07:46):
research into treatments forother viral diseases in cats or
even other animals.
It's already inspired, like Dr.
Černá, to do more research inusing two drugs together, which
is fantastic.
So in conclusion, the new FIPdrug represents a major
advancement in our feline healthcare.
It's a reminder of theimportance of the ongoing
(08:07):
research and development inveterinary medicine.
So we look forward to seeing thepositive impacts this drug is
going to have on the lives ofall 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 starreview.
And always please make sure totell somebody else about our
podcast.
We love when people talk abouthow much knowledge they've
(08:28):
gained from us.
Let's take a minute and we'regoing to talk about snails that
I promised you.
So snails are actually superinteresting.
People don't realize that.
Everyone knows that snails makemucus, right?
And that's the little mucustrail that they leave.
But, they use that to help themdo a couple of things.
One is to help them move.
They're not very good atmovement.
Actually their movement is justone little foot, right?
(08:51):
That just kind of like, squishesand then moves, and squishes and
moves.
And that's really, that takes alot of energy, unfortunately.
So they leave that trail becausethat helps them to be able to
move a little bit faster.
It also helps them stick tothings.
So stick to things like walls,right?
They can use their foot as asuction cup and move up the
wall.
(09:11):
The Costa Rican land snail,which I bet you didn't know
there was multiple snails, huh?
Costa Rican land snail uses thismucus to help invert itself
under a leaf.
So it's able to hide from thehot Sun.
It's gotta hang upside down inorder to be able to...
to hold on with this slime thatit produces.
Did you know that they alsoproduce this mucus to help
(09:33):
protect them from sharp objects?
So it just helps them glide overit and not like slice open their
foot to their vital organs.
So since they use this mucus formovement 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 areslow, how are they able to find
(09:54):
a mate and reproduce so quicklythen?
What if two males meet in thewild?
How long did it take them to getto that location in the first
place?
And then you have two males meetand you're like, ah, shoot, I
can't mate now, right?
A lot of them are actuallyhermaphrodites.
So when two males meet, they canboth technically inseminate each
other, and they can both produceeggs.
(10:16):
So then they produce about ahundred eggs that they wrap in
this really viscous goo, in awet area to help protect them.
So only a small percentage of'emare actually gonna survive
though due to the rain washingthem away and predators eating
them.
Since no one's really watchingover them, they're really just
protecting'em as goo.
So when they hatch, theyactually look like they have a
(10:37):
see through body that changes toa 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 witha guess now on how many teeth
that they have?
So their teeth are actuallycalled radula and they're
located on the tongue.
(10:57):
They have about 120 rows of 100teeth.
So most snails have about 12,000teeth.
And in some species, they haveabout 20,000 teeth.
They use these to scrape and cutall those leaves.
Seems like a really large amountof teeth just for plants, right?
But that's what they need to beable to use.
Lastly, let's talk about theirlifespan.
(11:19):
Most snails live to be about twoto five years old, which I
thought was just crazy.
When kept in captivity, they caneven live longer than that,
about 10 to 15 years on average,or even longer.
I just always assumed that theywere very fast hatching and then
fast to die unfortunately ofsome sort of circumstance.
(11:39):
From a bird eating them andstuff, but they can live for a
long time in the wild.
All right, thanks for joining meon this episode of
Vetsplanation.
If you have any questions ortopics you'd like me to cover,
please reach out to us on oursocial media or on our website.
I hope this demystifies the newFIP drug for you, and that
you've also learned somethingnew about snails and how they're
actually really interesting.
(12:00):
Until next time.
Please keep your pets happyhealthy and safe.
Thanks guys.
We'll see you next week
Today we're diving into an exciting development in
the world of feline medicine.
The new FIP drug is set to bereleased in June.
So actually we have talked aboutthis before.
We've talked about how there wasan FIP drug that has been used
but is illegal for us toprescribe on the black market.
So have you ever even thoughtabout buying a drug off the
(00:20):
black market for your cat?
We'll review FIP real quick, andif you stay till the end, we'll
talk about some crazy factsabout snails.
Did you know that snails haveteeth?
Like, how many teeth do youthink a snail has?
You'll be surprised when youfind out.
I'm Dr.
Sugerman, and welcome toVetsplanation, where we break
down the latest in veterinarymedicine for pet parents and
(00:41):
enthusiasts alike.
So let's jump into FIP.
All right, to start, let'sbriefly review what FIP is.
FIP, or feline infectiousperitonitis, is a viral disease
caused by a strain of felinecoronavirus.
So while cats might carry felinecoronavirus without showing
symptoms, a mutation in thevirus can lead to FIP, which, if
(01:06):
left untreated, is almost alwaysfatal.
If this is all news to you, youcan definitely go back to our
FIP episode where I discuss allof this in more detail.
People always think that themutation has to happen when
they're a baby, but actually themost 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
(01:28):
yellow flowers, all identicalwhen they come up, and I infect
them all with a virus thatcauses them to have some sort of
change.
But you don't really seeanything different with those
flowers.
But then maybe three weekslater, one of those flowers
changes to a blue color, wiltsaway, and dies.
They were all infected with thesame disease.
But only one of those virusesmutated to cause this flower to
(01:52):
die.
It changed what that virus wasin order to cause a worsening
illness.
Alright, back to cats since Idon't treat flowers.
There are two main forms of FIP.
So the wet, effusive form andthe dry, non effusive form.
The wet form causes fluid toaccumulate in places like the
(02:13):
abdomen or the chest.
While the dry form leads to theformation of things called
granulomas or basically likereally thick abscesses.
The dry form can affect theneurological system so the brain
or even the kidneys and even theeyes.
Both forms are severe and reallychallenging to treat.
(02:34):
Now, I know we all hated COVID,but there was something that was
really cool that came out of thepandemic.
There was this drug calledRemdesivir, that was used to
treat COVID patients, which is acoronavirus, just like in cats.
So remember the coronavirusmutates to FIP, but now there's
a glimmer of hope on thehorizon.
(02:55):
This June, a groundbreaking drugfor FIP is going to be set to be
released.
This drug, which is very similarto that Remdesivir.
Named GS-441524, and hopefullythey get a better name for this,
has shown remarkable efficacy inclinical trials.
So this GS-441524 works byinhibiting the replication or
(03:19):
stopping the replication of thevirus within the cat's body, so
it stops that virus from makingmore viruses.
In studies, it is not only shownto have improved survival rates,
but also reduced the symptomssignificantly.
For many cats diagnosed withFIP, this could mean a much
better prognosis and betterquality of life.
(03:41):
So let's talk about theseclinical trials.
The trials for GS-441524included a diverse group of cats
with both wet and dry forms ofFIP.
Dr.
Černá talked to us a little bitabout some of the study that she
had been doing as well, whichincluded those both wet and dry
forms too.
(04:02):
Hers was a bit different thanthese studies, but definitely
they had some very similaroutcomes.
So the results indicated that asurvival rate of over 80 percent
for the wet form, or effusiveFIP, and a bit lower,
unfortunately, for the dry FIP,which is unprecedented for this
disease.
That means that we went fromalmost 100 percent of our FIP
(04:23):
patients dying to about 80ishpercent living.
That is huge.
So before this drug, ourtreatment options were really
limited.
We largely did palliative care,focusing on symptom management
rather than actually a cure.
Then this drug, started to beresearched.
Now with GS-441524, we have atargeted antiviral treatment
(04:46):
that addresses the root of theproblem, or the root cause of
this disease.
The problem was though that youcould only legally get it if you
were doing a research trial, oryou would have to go on to the
black market to obtain this inorder to save your cat's life.
So there was a rumor that wasput out that GS-441524 will be
(05:09):
legal as of June 1st.
That is actually not true.
So the FDA or the Food DrugAdministration, who's in charge
of all the medications weprescribed, has stated that if a
veterinarian chooses toprescribe this medication, that
they just will not take anenforcement action.
Why does the FDA care, you mightask?
(05:31):
And why don't they just approvethis medication?
This medication is a compoundedmedication or basically it's
made from a bulk medicationwhere they take small amounts
from a more potent largermedication, which is not
something that's approved by theFDA and in fact is actually
illegal, which means thatlegally we cannot prescribe it.
(05:52):
And instead, we would just nudgeparents to be like, Hey, pet
parent, there's this really coolway that you could find this
drug to be able to save yourcat.
We would just nudge them towhere they could find it.
But we legally could notprescribe it, nor could we get
it for them.
So, GS-441524 is not a legaldrug.
But we can prescribe it now, soit's more like what we call a
(06:16):
gray market drug instead of ablack market drug.
We're not going to get introuble for prescribing it, but
it's technically not legal toprescribe it.
So the FDA put out a statementthat says that we can use it
because under Section GFI 256,Under certain conditions, the
FDA can elect not to enforceactions for compounded products
(06:39):
for use in animals.
Which is what we are saying withthis drug.
They're not saying it's going tobe legal, but they're saying
that they're not going toenforce any regulations on it.
So for pet parents, this meanshope, essentially.
If your cat is diagnosed withFIP, there is now a viable
treatment option that can offera real chance at recovery for
(07:01):
these cats.
However, it is important to notethat this drug is likely going
to be expensive because it mightnot be immediately available in
all regions.
Availability and cost are alwaysconcerns with these new
treatments.
It is really crucial for catparents to discuss this option
with their veterinarian so thatyou can best understand what the
best course of action is foryour pet.
(07:24):
So looking ahead, the release ofGS-441524 is a significant
milestone in veterinarymedicine.
It also opens the door forfurther research into antiviral
treatments for lots of othertypes of diseases.
This could just be thebeginning.
The success of GS-441524 mightinspire more investment and more
(07:46):
research into treatments forother viral diseases in cats or
even other animals.
It's already inspired, like Dr.
Černá, to do more research inusing two drugs together, which
is fantastic.
So in conclusion, the new FIPdrug represents a major
advancement in our feline healthcare.
It's a reminder of theimportance of the ongoing
(08:07):
research and development inveterinary medicine.
So we look forward to seeing thepositive impacts this drug is
going to have on the lives ofall 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 starreview.
And always please make sure totell somebody else about our
podcast.
We love when people talk abouthow much knowledge they've
(08:28):
gained from us.
Let's take a minute and we'regoing to talk about snails that
I promised you.
So snails are actually superinteresting.
People don't realize that.
Everyone knows that snails makemucus, right?
And that's the little mucustrail that they leave.
But, they use that to help themdo a couple of things.
One is to help them move.
They're not very good atmovement.
Actually their movement is justone little foot, right?
(08:51):
That just kind of like, squishesand then moves, and squishes and
moves.
And that's really, that takes alot of energy, unfortunately.
So they leave that trail becausethat helps them to be able to
move a little bit faster.
It also helps them stick tothings.
So stick to things like walls,right?
They can use their foot as asuction cup and move up the
wall.
(09:11):
The Costa Rican land snail,which I bet you didn't know
there was multiple snails, huh?
Costa Rican land snail uses thismucus to help invert itself
under a leaf.
So it's able to hide from thehot Sun.
It's gotta hang upside down inorder to be able to...
to hold on with this slime thatit produces.
Did you know that they alsoproduce this mucus to help
(09:33):
protect them from sharp objects?
So it just helps them glide overit and not like slice open their
foot to their vital organs.
So since they use this mucus formovement 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 areslow, how are they able to find
(09:54):
a mate and reproduce so quicklythen?
What if two males meet in thewild?
How long did it take them to getto that location in the first
place?
And then you have two males meetand you're like, ah, shoot, I
can't mate now, right?
A lot of them are actuallyhermaphrodites.
So when two males meet, they canboth technically inseminate each
other, and they can both produceeggs.
(10:16):
So then they produce about ahundred eggs that they wrap in
this really viscous goo, in awet area to help protect them.
So only a small percentage of'emare actually gonna survive
though due to the rain washingthem away and predators eating
them.
Since no one's really watchingover them, they're really just
protecting'em as goo.
So when they hatch, theyactually look like they have a
(10:37):
see through body that changes toa 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 witha guess now on how many teeth
that they have?
So their teeth are actuallycalled radula and they're
located on the tongue.
(10:57):
They have about 120 rows of 100teeth.
So most snails have about 12,000teeth.
And in some species, they haveabout 20,000 teeth.
They use these to scrape and cutall those leaves.
Seems like a really large amountof teeth just for plants, right?
But that's what they need to beable to use.
Lastly, let's talk about theirlifespan.
(11:19):
Most snails live to be about twoto five years old, which I
thought was just crazy.
When kept in captivity, they caneven live longer than that,
about 10 to 15 years on average,or even longer.
I just always assumed that theywere very fast hatching and then
fast to die unfortunately ofsome sort of circumstance.
(11:39):
From a bird eating them andstuff, but they can live for a
long time in the wild.
All right, thanks for joining meon this episode of
Vetsplanation.
If you have any questions ortopics you'd like me to cover,
please reach out to us on oursocial media or on our website.
I hope this demystifies the newFIP drug for you, and that
you've also learned somethingnew about snails and how they're
actually really interesting.
(12:00):
Until next time.
Please keep your pets happyhealthy and safe.
Thanks guys.
We'll see you next week
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