The London Cat Clinic is acutely aware of novel FIP treatment modalities being offered and readily available on the black market. As feline clinicians we understand the dire need for effective treatment of this inevitably fatal disease. We understand the emotion that drives the decision-making process to obtain such drugs from sources that are not commercially or legally available to us.
The University of California, Davis has provided pilot studies involving GS-441524 (nucleoside analogue) and GC376 (protease inhibitor) with very promising results. Since these studies were first published, oral and injectable formulations of the drugs have been offered online, unlicensed by the patent holder Gilead Sciences Inc. and not subject to any external quality control. More information can be found on the University of California, School of Veterinary Medicine website
The London Cat Clinic cannot promote the use of such unlicensed products of unknown composition, shelf-life, concentration, toxicity and efficacy and neither can we advise on dosage, frequency, duration of treatment or appropriate monitoring of side effects as this is in stark conflict with the Royal College of Veterinary Surgeons’ Code of Professional Conduct.
However, the welfare of our patients is of the highest priority and we will in all cases fulfil our ethical and legal duty to ensure the individual cat’s medical care is not neglected, should a client consider using the above medications for their cat.
Confirmation of the diagnosis of FIP must be sought whenever possible to ensure cats not suffering from FIP are not put at an unacceptable risk by the inappropriate use of an unlicensed drug, or of having more suitable treatment withheld if the disease isn’t in fact FIP.
As veterinarians we are here to ensure that owners of cats with FIP that have chosen to pursue unlicensed therapy are not compromising the individual cat's welfare by neglecting medical care, especially should treatment be unsuccessful or in the event of the development of adverse reactions, which are at the moment impossible to predict.
We are prepared to monitor the clinical evolution of the patient undergoing treatment and discuss palliative care options if necessary. Scheduling of repeat exams and further tests depend on disease progression or clinical improvement and the available and growing evidence in the scientific literature.
It has come to our attention that some manufacturers of GS-442524 are currently advising their customers to have their cats undergo frequent blood tests and ultrasound scans to monitor the treatment outcome. Whilst close monitoring of patients is of course good medical practice, there are some major concerns about this.
1) These companies are not subject to any ethical or scientific review and have an obvious conflict of interest in publishing their results.
2) Owners are being recruited into ongoing studies and asked to commit to a monitoring schedule that did not undergo any such review. In the UK, scientific studies on animals require licensure under the Animal (Scientific Procedures) Act 1986 which regulates procedures that may cause pain, distress, suffering or lasting harm to animals. The Veterinary Surgeons Act 1966 which regulates the veterinary profession does not cover elective, scientific procedures. We are hence legally and ethically bound to not carry out procedures without a clear clinical need.
At the moment, no monitoring schedules beyond the original publications proving the drug's efficacy have been published to justify this need and we are legally and ethically prohibited from performing elective procedures (that could pose a stressor to the cat’s immune system) without a clinical benefit for the individual cat.