New drug to treat serious feline disease
Fruitful collaboration between vets and pharmacy
Feline Infectious Peritonitis (FIP) is a serious feline disease with a fatal outcome. Thanks to a fruitful collaboration between vets from the Academic Veterinary Hospital in Utrecht, Anicura Haaglanden in Rijswijk, Evidensia Veterinary Hospital Arnhem and the pharmacy of the Academic Veterinary Hospital in Utrecht, a safe and carefully controlled drug to treat FIP has recently been developed. Vets , Marja de Jong and tell us about this collaborative project.
I never thought I would see a drug to treat this serious feline disease during my working life as a vet
Unique collaboration between veterinary hospitals
Knies got fellow vets Marja de Jong and Marleen Assink on board. This gave rise to a unique collaboration between the Academic Veterinary Hospital in Utrecht, Anicura Haaglanden in Rijswijk and Evidensia Veterinary Hospital Arnhem. It also allowed pet owners to take their cats to three different locations in the Netherlands. Assink (Evidensia Veterinary Hospital Arnhem) responded enthusiastically when Knies asked her to get involved. "I felt it was such a unique opportunity. When I became a vet, I never thought I would see a drug to treat FIP during my working life. We鈥檙e really making history in the Netherlands."
The announcement by the three vets of the start of a research project on a new drug to treat FIP was followed by an exciting and hectic period. FIP patients or cats that were thought to have FIP came to the participating veterinary hospitals from all corners of the Netherlands.
Mutual support in trying times
Assink: "It was a difficult period. Initially, I underestimated the impact on our hospital and the burden that it would put on everyone. Luckily, Marieke and I have always worked very closely with each other; if we ran into a problem, we were able to resolve it pretty quickly. The fact that everyone was so passionate about this project also helped ensure that it all kept running smoothly."
It鈥檚 so nice to know that you鈥檙e not in this on your own and you can run ideas by each other
Knies adds: "What we do during the study is based on previous studies, of course, but it鈥檚 still stressful waiting to see what鈥檚 going to happen. For example, in cats with a particular variant of the disease [wet FIP, where fluid builds up in the abdominal cavity and chest, ed.], we saw a particular protein group (gamma globulins) rise during the initial blood tests, whereas it should go down. We now know that this isn鈥檛 an issue, because these proteins go down again after two weeks. In a situation like that, it鈥檚 so nice to know that you鈥檙e not in this on your own and to be able to check with others whether they are seeing this happening too."
De Jong (Academic Veterinary Hospital) also looks back: "Doing research with patients is quite tough because there鈥檚 always something going on. You鈥檙e effectively on tenterhooks 24 hours a day, because you know that a colleague from the Intensive Care Unit can WhatsApp you with questions even at the weekend. So it鈥檚 really good to able to share your experiences." Sometimes, a seriously ill patient dies. "At times like that, supporting each other and staying positive together is crucial." Fortunately, the majority of cats go home after diagnosis and are given medication in the form of capsules. "Owners can open the capsules and mix them with the powder, to make it more palatable for the cat," says De Jong.
No longer a death sentence
Knies, De Jong and Assink have seen 135 cats in 5 months, when they were expecting to see 50. "It's just manically busy, everyone鈥檚 working flat out," says Knies. What next? "For the time being, we prefer to keep the diagnostics in our own hands, because sometimes we get patients coming in with a diagnosis of FIP, and then on further investigation it turns out to be something else." A real-life example is a cat with fluid in the abdominal cavity, a symptom that is consistent with FIP, but the cat was found to have peritonitis caused by bacteria. "We only have one drug to treat FIP, and we know that both humans and cats can become resistant to the drug, so I want to be careful in how I use it. But we do want to release monitoring to vets throughout the Netherlands."
We mustn鈥檛 think that there is now a miracle cure that will make every cat better. But many cats now have a real chance
The fact that vets refer cats that turn out not to have FIP doesn鈥檛 bother them. The most important thing is to act quickly and to stop seeing FIP as a death sentence for the cat. De Jong: "FIP is a serious disease, and we mustn鈥檛 think that there is now a miracle cure that will make every cat better. But there is a real chance for many cats." De Jong also wants to convey this to students on the Veterinary Medicine programme who are doing their placements. "They see a lot of cats with FIP and will shortly enter the profession, so they鈥檒l recognise it more quickly. Hopefully, this will prevent all kinds of weekend, night and emergency situations in the future."
In a cat with this serious disease, acting fast is important
Marijn Baar participated with her cat Sammie in the Feline Infectious Peritonitis (FIP) study by the Academic Veterinary Hospital of Utrecht 木瓜福利影视, Anicura Haaglanden and Evidensia Veterinary Hospital Arnhem. Sammie was seriously ill and was deteriorating rapidly. If Baar had done nothing, her cat would have died. The new medication and guidance from a vet helped Sammie pull through. How does Baar look back on her participation in the study and guidance on the treatment? A retrospective.
"We were lucky that it happened to Sammie now and not three years ago, because, back then, she wouldn鈥檛 have made it," says owner Marijn Baar. Her cat had her last check-up a few days ago. "She still has a slightly enlarged spleen, probably because her protein level is a bit too high. The vet who is treating her expects this to rectify itself and is doing a final test. Sammie is doing well, she鈥檚 eating well and she鈥檚 happy. But even if she hadn鈥檛 made it, I would have stood by my choice."
Act fast
"My own vet suspected FIP and told me about the study, but mentioned that it was expensive, too," says Baar. She searched the Internet for information and read publications on previous studies. "I had two options. I could either buy medication through Facebook and inject it myself, but I wasn't keen on that, or I could take part in the FIP study under the guidance of a vet. When a cat has FIP, it鈥檚 important to act fast. When I realised that Sammie was deteriorating very quickly, I decided to email Marieke Knies. I got an email back right away."
Empathy, passion and support
Baar took her cat Sammie to Anicura Haaglanden in Rijswijk for a diagnosis. "The vet told me how enthusiastic the researchers were and how well the drug works. It was obvious how much time they put into their work and how passionate they were about it." She was given information about the treatment and check-ups. There was room for Sammie at the Academic Veterinary Hospital in Utrecht. "Everything was well coordinated, and everyone was empathetic and compassionate. It鈥檚 an intense process; sometimes, other people have no idea what you鈥檙e going through. That鈥檚 when talking to people who understand you is great. I'm glad I was able to do this for Sammie. I see now what kind of cat she actually is."
Crucial role of colleagues and pet owners
Finally, Knies stresses that they would never have managed to help so many cats without the efforts of colleagues from the Veterinary Medicine pharmacy. "They developed capsules as if their lives depended on it. And it was exciting for them to launch a new drug, too." But the efforts of colleagues from the Academic Veterinary Diagnostic Laboratory and Veterinary Medicine鈥檚 Veterinary Microbiological Diagnostic Centre, vets, animal nurses and support staff within the clinics were also indispensable. Assink: "Pet owners who come to us with a sick cat are super worried. Anything they see and notice, they call about. And there would always be someone there with a listening ear who could then help them."
De Jong: 鈥淭he trust that pet owners with their sick cats had in us was extremely valuable to us, as was what they told us about how their cats reacted to the medication. This has provided us with a wealth of information for cats with FIP in the future."
More information
To find out more about this treatment, email fip@uu.nl.
The drug referred to in the first paragraph is a dietary supplement with a medical claim, which does not have the pharmaceutical checks that are associated with drugs. Recently, so-called magistrally prepared medication (prepared by a pharmacist or vet themselves in the absence of a suitable veterinary medicine) has become available in the UK and elsewhere. This medication cannot be imported due to EU legislation. You can find out more about this on the pharmacy鈥檚 website: under Laws and regulations.
Text: Renske Belt