Feline infectious peritonitis (FIP) is a fatal disease caused by feline coronavirus or its variant, referred to as the FIP virus. Recently, favorable treatment outcomes of the anti-viral drug Mutian® Xraphconn (Mutian X) were noted in cats with FIP. Thus, the therapeutic efficacy of Mutian X in cats with FIP must be explored, although the predictors of therapeutic success remain unknown. In the present study, we administered Mutian X to 141 pet cats with effusive FIP following initial veterinarian examinations. Of these, 116 cats survived but the remaining 25 died during treatment. Pre-treatment signalment, viral gene expression, and representative laboratory parameters for routine FIP diagnosis (i.e., hematocrit, albumin-to-globulin ratio, total bilirubin, serum amyloid-A, and α1-acid glycoprotein) were statistically compared between the survivor and non-survivor groups. The majority of these parameters, including hematocrit, albumin-to-globulin ratio, serum amyloid-A, α1-acid glycoprotein, and viral gene expression, were comparable between the two groups. Interestingly, however, total bilirubin levels in the survivor group were significantly lower than those in the non-survivor group (p < 0.0001). Furthermore, in almost all surviving cats with effusive FIP (96.6%, 28/29), the pre-treatment total bilirubin levels were below 0.5 mg/dL; however, the survival rate decreased drastically (14.3%, 1/7) when the pre-treatment total bilirubin levels exceeded 4.0 mg/dL. Thus, circulating total bilirubin levels may act as a prognostic risk factor for severe FIP and may serve as the predictor of the therapeutic efficacy of Mutian X against this fatal disease.
Feline infectious peritonitis (FIP) is a fatal disease classified as either effusive, non-effusive (‘dry’), or a mixture (‘mixed’) of the forms of FIP, with mixed showing signs of both effusive and dry. To determine whether the therapeutic effect of Mutian on dry and mixed FIP can be predicted using clinical indicators before starting treatment, we entered 161 cats with mixed FIP and 163 cats with dry FIP into this study. Physical assessments, the reverse transcriptase-PCR detection of viral genes, and clinical laboratory tests (hematocrit, albumin/globulin ratio, serum amyloid A, α1-acid glycoprotein, and total bilirubin) were performed before Mutian was administered. These indicators were compared between the FIP groups that survived after receiving Mutian for 84 days and those that died before the completion of treatment. Significant differences in body temperature, appetite, and activity scores were confirmed between the surviving and non-surviving groups. The therapeutic effect was insufficient when total bilirubin levels increased in cats with the mixed form. In both of the FIP types, therapeutic effects were difficult to obtain when neurological clinical signs were observed. The therapeutic effects of Mutian on the cats with dry and mixed FIP can be predicted based on pre-treatment body temperature, appetite scores, and activity scores, as well as the presence of neurological signs.
Background: Feline infectious peritonitis (FIP) is a fatal disease caused by feline coronavirus or its mutated pathogen designated as FIP virus. The most common form of FIP is wet or effusive, with non- regenerative anemia and clinical signs of mainly non-specific, such as recurrent fever, anorexia and weight loss. Recently, promising results using new anti-viral drug for treating cats with FIP were observed, but identification of rescuable FIP has been still challenging. It is highly worth to identify infected cats possible to be saved by such an anti-viral agent.Methods: At the initial veterinarian’s examination, owner inquiry-based signalments, viral gene detection by PCR and representative laboratory tests for diagnosis of FIP including hematocrit, A to G ratio, total bilirubin, serum amyloid-A and α1-acid globulin of 141 cats with effusive FIP were compared with those of 28 non-FIP disease cats. Consequently, 116 of them were rescued by administration of anti-viral drug Mutian X and the residual 25 were deceased unfortunately under treatments. Clinical and laboratory indicators observed prior to initial medication were also evaluated statistically between survived and non-survived groups.Results: Expectedly, levels for a few items of signalments (appetitive and activity scores), hematocrit, A to G ratio, total bilirubin, serum amyloid-A, α1-acid globulin and viral gene were found to be distributed distinctively between 141 FIP and 28 non-FIP cats. In the comparison between survived and non-survived FIP cats, most of their parameters including levels for hematocrit, A to G ratio, serum amyloid-A, α1-acid globulin and viral gene were not statistically different. Interestingly, total bilirubin concentrations of survived FIP cats were declined significantly than those of non-survived, and similarly, body temperatures, appetitive and activity scores appeared to be higher probably in accordance with their physical condition.Conclusions: Several clinical and laboratory indicators were informative in diagnosis of effusive FIP. We have investigated that one of the quantitative markers, total bilirubin levels, tend to be distributed characteristically in rescuable cats with effusive FIP. Elevated levels of total bilirubin may be a prognostic risk factor for severe FIP, predicting no clinical benefit obtained by using Mutian X as a therapeutic agent.
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