Optionen zur Therapie der felinen infektiösen Peritonitis – früher und heute

Zusammenfassung

Die feline infektiöse Peritonitis (FIP) ist eine der häufigsten Infektionskrankheiten bei Katzen und verläuft unbehandelt tödlich. Bisher gibt es in Deutschland keine legal verfügbare wirksame Therapie. Therapieoptionen reichen von der symptomatischen Therapie (z. B. Glukokortikoide, Propentofyllin) über immunmodulatorische Ansätze (z. B. Interferone, Polyprenyl-Immunstimulanz) bis hin zur antiviralen Therapie mit einem Protease-Inhibitor (z. B. GC376) oder Nukleosid-Analoga (z. B. GS-441524, Remdesivir). Die symptomatische Therapie führt nicht zur Heilung der FIP, sondern nur zu einer kurzzeitigen Verbesserung der klinischen Symptome bei wenigen Katzen. Auch eine immunmodulatorische Therapie stellte sich als wenig erfolgversprechend heraus. Die antiviralen Medikamente GS-441524 und GC376 waren in mehreren Studien hochwirksam und konnten das Leben vieler an FIP erkrankten Katzen retten. Beide Wirkstoffe sind aktuell in Deutschland nicht zugelassen und können von Tierärzten nicht legal angewendet werden. Katzen dürfen aktuell nur in wenigen Ländern (z. B. Großbritannien und Australien) legal mit GS-441524 therapiert werden. GS-441524 wird daher von Katzenbesitzern in vielen anderen Ländern über den Schwarzmarkt bestellt und in Eigenregie angewendet. Dieser Artikel gibt eine Übersicht über verfügbare Therapieoptionen und einen Ausblick zur legalen Anwendung wirksamer antiviraler Medikamente.

Abstract

Feline infectious peritonitis (FIP) is one of the most common infectious diseases in cats that is fatal when untreated. So far, there is no legally available effective treatment in Germany. Treatment options include only symptomatic treatment (e. g. glucocorticoids, propentofylline), immunomodulatory approaches (e. g. interferons, polyprenyl immunostimulant), and antiviral chemotherapy with protease inhibitors (e. g. GC376) or nucleoside analogues (e. g. GS-441524, remdesivir). Symptomatic treatment does not cure FIP but may lead to a short-term improvement of clinical signs in a subset of cats. Immunomodulatory treatment has also not shown to be very promising. In contrary, the antiviral compounds GS-441524 and GC376 exhibited significant efficacy in several studies and their use saved the lives of many cats suffering from FIP. However, both agents are currently not licensed and thus cannot be legally administered by veterinarians in Germany. Legally, cats may only be legally treated with GS-441524 in a few countries (e.g. Great Britain and Australia). In other countries, GS-441524 is imported by cat owners via the black market and administered on their own. This article provides an overview of the available treatment options and an outlook on the legal use of effective antiviral drugs.

Schlüsselwörter

FIP - Behandlung - antivirale Chemotherapie - GS-441524 - FCoV - felines Coronavirus

Key words

FIP - treatment - antiviral chemotherapy - GS-441524 - FCoV - felines Coronavirus

Publication History

Received: 11 February 2023

Accepted: 31 March 2023

Article published online:
13 November 2023

• 1 Cave TA, Thompson H, Reid SW. et al. Kitten mortality in the United Kingdom: a retrospective analysis of 274 histopathological examinations (1986 to 2000). Vet Rec 2002; 151: 497-501 DOI: 10.1136/vr.151.17.497.
• 2 Ritz S, Egberink H, Hartmann K. Effect of feline interferon-omega on the survival time and quality of life of cats with feline infectious peritonitis. J Vet Intern Med 2007; 21: 1193-1197 DOI: 10.1892/06-302.1.
• 3 Lai MM, Cavanagh D. The molecular biology of coronaviruses. Adv Virus Res 1997; 48: 1-100 DOI: 10.1016/s0065-3527(08)60286-9.
• 4 Woo PC, Lau SK, Huang Y. et al. Coronavirus diversity, phylogeny and interspecies jumping. Exp Biol Med 2009; 234: 1117-1127 DOI: 10.3181/0903-mr-94.
• 5 Woo PC, Lau SK, Lam CS. et al. Discovery of seven novel mammalian and avian coronaviruses in the genus deltacoronavirus supports bat coronaviruses as the gene source of alphacoronavirus and betacoronavirus and avian coronaviruses as the gene source of gammacoronavirus and deltacoronavirus. J Virol 2012; 86: 3995-4008 DOI: 10.1128/jvi.06540-11.
• 6 Pedersen NC, Boyle JF, Floyd K. Infection studies in kittens, using feline infectious peritonitis virus propagated in cell culture. Am J Vet Res 1981; 42: 363-367
• 7 Pedersen NC, Boyle JF, Floyd K. et al. An enteric coronavirus infection of cats and its relationship to feline infectious peritonitis. Am J Vet Res 1981; 42: 368-377
• 8 Pedersen NC, Black JW, Boyle JF. et al. Pathogenic differences between various feline coronavirus isolates. Adv Exp Med Biol 1984; 173: 365-380 DOI: 10.1007/978-1-4615-9373-7_36.
• 9 Addie DD, Jarrett O. A study of naturally occurring feline coronavirus infections in kittens. Vet Rec 1992; 130: 133-137 DOI: 10.1136/vr.130.7.133.
• 10 Addie DD, Toth S, Murray GD. et al. Risk of feline infectious peritonitis in cats naturally infected with feline coronavirus. Am J Vet Res 1995; 56: 429-434
• 11 Pedersen NC. A review of feline infectious peritonitis virus infection: 1963-2008. J Feline Med Surg 2009; 11: 225-258 DOI: 10.1016/j.jfms.2008.09.008.
• 12 Pedersen NC, Liu H, Dodd KA. et al. Significance of coronavirus mutants in feces and diseased tissues of cats suffering from feline infectious peritonitis. Viruses 2009; 1: 166-184 DOI: 10.3390/v1020166.
• 13 Desmarets LM, Vermeulen BL, Theuns S. et al. Experimental feline enteric coronavirus infection reveals an aberrant infection pattern and shedding of mutants with impaired infectivity in enterocyte cultures. Sci Rep 2016; 6: 20022 DOI: 10.1038/srep20022.
• 14 Woo PC, Huang Y, Lau SK. et al. Coronavirus genomics and bioinformatics analysis. Viruses 2010; 2: 1804-1820 DOI: 10.3390/v2081803.
• 15 Poland AM, Vennema H, Foley JE. et al. Two related strains of feline infectious peritonitis virus isolated from immunocompromised cats infected with a feline enteric coronavirus. J Clin Microbiol 1996; 34: 3180-3184 DOI: 10.1128/jcm.34.12.3180-3184.1996.
• 16 Vennema H, Poland A, Foley J. et al. Feline infectious peritonitis viruses arise by mutation from endemic feline enteric coronaviruses. Virology 1998; 243: 150-157 DOI: 10.1006/viro.1998.9045.
• 17 Tasker S, Addie DD, Egberink H et al. Feline infectious peritonitis: European Advisory Board on Cat Diseases guidelines. Viruses 2023; 15(9): 1847. DOI: 10.3390/v15091847 https://www.abcdcatsvets.org/wp-content/uploads/2022/12/ABCD-FCoV-FIP-Guidelines-April-2022.pdf
• 18 Kipar A, Meli ML. Feline infectious peritonitis: still an enigma?. Vet Pathol 2014; 51: 505-526 DOI: 10.1177/0300985814522077.
• 19 Sparkes AH, Gruffydd-Jones TJ, Harbour DA. Feline infectious peritonitis: a review of clinicopathological changes in 65 cases, and a critical assessment of their diagnostic value. Vet Rec 1991; 129: 209-212 DOI: 10.1136/vr.129.10.209.
• 20 Tsai HY, Chueh LL, Lin CN. et al. Clinicopathological findings and disease staging of feline infectious peritonitis: 51 cases from 2003 to 2009 in Taiwan. J Feline Med Surg 2011; 13: 74-80 DOI: 10.1016/j.jfms.2010.09.014.
• 21 Riemer F, Kuehner KA, Ritz S. et al. Clinical and laboratory features of cats with feline infectious peritonitis – a retrospective study of 231 confirmed cases (2000–2010). J Feline Med Surg 2016; 18: 348-356 DOI: 10.1177/1098612x15586209.
• 22 Kent M. The cat with neurological manifestations of systemic disease. Key conditions impacting on the CNS. J Feline Med Surg 2009; 11: 395-407 DOI: 10.1016/j.jfms.2009.03.007.
• 23 Pedersen NC. An update on feline infectious peritonitis: diagnostics and therapeutics. Vet J 2014; 201: 133-141 DOI: 10.1016/j.tvjl.2014.04.016.
• 24 European advisory board on cat diseases (ABCD). FIP diagnosis tool (2021). Im Internet: https://www.abcdcatsvets.org/wp-content/uploads/2022/11/TOOL_FIP_Feline_infectious_peritonitis_December_2021_EN.pdf. Stand 07.02.2023
• 25 Andrew SE. Feline infectious peritonitis. Vet Clin North Am Small Anim Pract 2000; 30: 987-1000 DOI: 10.1016/s0195-5616(00)05002-6.
• 26 Felten S, Hartmann K. Diagnosis of feline infectious peritonitis: a review of the current literature. Viruses 2019; 11: 1068 DOI: 10.3390/v11111068.
• 27 Thayer V, Gogolski S, Felten S. et al. 2022 AAFP/everycat feline infectious peritonitis diagnosis guidelines. J Feline Med Surg 2022; 24: 905-933 DOI: 10.1177/1098612x221118761.
• 28 Fischer Y, Ritz S, Weber K. et al. Randomized, placebo controlled study of the effect of propentofylline on survival time and quality of life of cats with feline infectious peritonitis. J Vet Intern Med 2011; 25: 1270-1276 DOI: 10.1111/j.1939-1676.2011.00806.x.
• 29 Hugo TB, Heading KL. Prolonged survival of a cat diagnosed with feline infectious peritonitis by immunohistochemistry. Can Vet J 2015; 56: 53-58
• 30 Hiraku S, Taniguchi K, Wakitani K. et al. Pharmacological studies on the TXA2 synthetase inhibitor (E)-3-[p-(1H-imidazol-1-ylmethyl)phenyl]-2-propenoic acid (OKY-046). Jpn J Pharmacol 1986; 41: 393-401 DOI: 10.1254/jjp.41.393.
• 31 Watari T, Kaneshima T, Tsujimoto H. et al. Effect of thromboxane synthetase inhibitor on feline infectious peritonitis in cats. J Vet Med Sci 1998; 60: 657-659 DOI: 10.1292/jvms.60.657.
• 32 Strieter RM, Remick DG, Ward PA. et al. Cellular and molecular regulation of tumor necrosis factor-alpha production by pentoxifylline. Biochem Biophys Res Commun 1988; 155: 1230-1236 DOI: 10.1016/s0006-291x(88)81271-3.
• 33 Deeva AVOS, Novikov AY. et al. Phosprenyl – an antiviral substance with a broad spectrum of action. Veterinar (In Russian) 1998; 3: 15-21
• 34 Narovlianskiy AN, Ershov FI, Kuritz T. Cytokine mRNA profile in cell lineMG-63with andwithout inductionwith phosprenyl and kagotsel. Abstr Eur Cytokine Netw 1998; 9: 515
• 35 Legendre AM, Bartges JW. Effect of polyprenyl immunostimulant on the survival times of three cats with the dry form of feline infectious peritonitis. J Feline Med Surg 2009; 11: 624-626 DOI: 10.1016/j.jfms.2008.12.002.
• 36 Legendre AM, Kuritz T, Galyon G. et al. Polyprenyl immunostimulant treatment of cats with presumptive non-effusive feline infectious peritonitis in a field study. Front Vet Sci 2017; 4: 7 DOI: 10.3389/fvets.2017.00007.
• 37 Perry AL, Lambert PA. Propionibacterium acnes. Lett Appl Microbiol 2006; 42: 185-188 DOI: 10.1111/j.1472-765X.2006.01866.x.
• 38 Weiss RC, Cox NR, Oostrom-Ram T. Effect of interferon or Propionibacterium acnes on the course of experimentally induced feline infectious peritonitis in specific-pathogen-free and random-source cats. Am J Vet Res 1990; 51: 726-733
• 39 Weiss RC, Oostrom-Ram T. Inhibitory effects of ribavirin alone or combined with human alpha interferon on feline infectious peritonitis virus replication in vitro. Vet Microbiol 1989; 20: 255-265 DOI: 10.1016/0378-1135(89)90049-7.
• 40 Zeidner NS, Myles MH, Mathiason-DuBard CK. et al. Alpha interferon (2b) in combination with zidovudine for the treatment of presymptomatic feline leukemia virus-induced immunodeficiency syndrome. Antimicrob Agents Chemother 1990; 34: 1749-1756 DOI: 10.1128/aac.34.9.1749.
• 41 Ishida T, Shibanai A, Tanaka S. et al. Use of recombinant feline interferon and glucocorticoid in the treatment of feline infectious peritonitis. J Feline Med Surg 2004; 6: 107-109 DOI: 10.1016/j.jfms.2003.08.011.
• 42 Addie DD, Covell-Ritchie J, Jarrett O. et al. Rapid resolution of non-effusive feline infectious peritonitis uveitis with an oral adenosine nucleoside analogue and feline interferon omega. Viruses 2020; 12: 1216 DOI: 10.3390/v12111216.
• 43 Malin JJ, Bunse T, Spinner CD. et al. Antiviral drugs: potent agents, promising therapies for COVID‑19 and therapeutic limitations. Internist 2022; 63: 118-128 DOI: 10.1007/s00108-021-01233-4.
• 44 Nicholson KG. Properties of antiviral agents. 2. Lancet 1984; 2: 562-564 DOI: 10.1016/s0140-6736(84)90774-8.
• 45 Reines ED, Gross PA. Antiviral agents. Med Clin North Am 1988; 72: 691-715 DOI: 10.1016/s0025-7125(16)30766-0.
• 46 Weiss RC, Cox NR, Martinez ML. Evaluation of free or liposome-encapsulated ribavirin for antiviral therapy of experimentally induced feline infectious peritonitis. Res Vet Sci 1993; 55: 162-172 DOI: 10.1016/0034-5288(93)90076-r.
• 47 McDonagh P, Sheehy PA, Norris JM. Identification and characterisation of small molecule inhibitors of feline coronavirus replication. Vet Microbiol 2014; 174: 438-447 DOI: 10.1016/j.vetmic.2014.10.030.
• 48 McDonagh P, Sheehy PA, Norris JM. In vitro inhibition of feline coronavirus replication by small interfering RNAs. Vet Microbiol 2011; 150: 220-229 DOI: 10.1016/j.vetmic.2011.01.023.
• 49 Yu J, Kimble B, Norris JM. et al. Pharmacokinetic profile of oral administration of mefloquine to clinically normal cats: a preliminary in-vivo study of a potential treatment for feline infectious peritonitis (FIP). Animals 2020; 10: 1000 DOI: 10.3390/ani10061000.
• 50 Mejias YG. SFM Protocol: An update on a treatment of feline infectious peritonitis in the UK November 2021. Im Internet: https://forum.icatcare.org/blogs/yaiza-gomez-mejias/2021/11/26/isfm-protocol-an-update-on-a-treatment-of-feline-i. Stand 07.02.2023
• 51 Taylor S, Tasker S, Gunn-Moore D, et al. An update on treatment of FIP in the UK (Februar 2022). Im Internet: https://www.vettimes.co.uk/article/an-update-on-treatment-of-fip-in-the-uk-cpdfip/ Stand 26.09.2023
• 52 Takano T, Akiyama M, Doki T. et al. Antiviral activity of itraconazole against type I feline coronavirus infection. Vet Res 2019; 50: 5 DOI: 10.1186/s13567-019-0625-3.
• 53 Takano T, Endoh M, Fukatsu H. et al. The cholesterol transport inhibitor U18666A inhibits type I feline coronavirus infection. Antiviral Res 2017; 145: 96-102 DOI: 10.1016/j.antiviral.2017.07.022.
• 54 Takano T, Wakayama Y, Doki T. Endocytic pathway of feline coronavirus for cell entry: differences in serotype-dependent viral entry pathway. Pathogens 2019; 8: 300 DOI: 10.3390/pathogens8040300.
• 55 Doki T, Takahashi K, Hasegawa N. et al. In vitro antiviral effects of GS-441524 and itraconazole combination against feline infectious peritonitis virus. Res Vet Sci 2022; 144: 27-33 DOI: 10.1016/j.rvsc.2022.01.005.
• 56 Doki T, Toda M, Hasegawa N. et al. Therapeutic effect of an anti-human-TNF-alpha antibody and itraconazole on feline infectious peritonitis. Arch Virol 2020; 165: 1197-1206 DOI: 10.1007/s00705-020-04605-7.
• 57 Kameshima S, Kimura Y, Doki T. et al. Clinical efficacy of combination therapy of itraconazole and prednisolone for treating effusive feline infectious peritonitis. J Vet Med Sci 2020; 82: 1492-1496 DOI: 10.1292/jvms.20-0049.
• 58 Clinipharm. Informationen zu Itrafungol™ 10 mg/ml ad us. vet., Lösung zum Eingeben für Katzen. Im Internet: https://www.vetpharm.uzh.ch/tak/05000000/00057369.01. Stand 07.02.2023
• 59 Gordon CJ, Tchesnokov EP, Schinazi RF. et al. Molnupiravir promotes SARS-CoV-2 mutagenesis via the RNA template. J Biol Chem 2021; 297: 100770 DOI: 10.1016/j.jbc.2021.100770.
• 60 Cook SE, Vogel H, Castillo D. et al. Investigation of monotherapy and combined anticoronaviral therapies against feline coronavirus serotype II in vitro. J Feline Med Surg 2022; 24: 943-953 DOI: 10.1177/1098612x211048647.
• 61 Cook S, Wittenburg L, Yan VC. et al. An optimized bioassay for screening combined anticoronaviral compounds for ffficacy against feline infectious peritonitis virus with pharmacokinetic analyses of GS-441524, remdesivir, and molnupiravir in cats. Viruses 2022; 4: 2429 DOI: 10.3390/v14112429.
• 62 Roy M, Jacque N, Novicoff W. et al. Unlicensed molnupiravir is an effective rescue treatment following failure of unlicensed GS-441524-like therapy for cats with suspected feline infectious peritonitis. Pathogens 2022; 11: 1209 DOI: 10.3390/pathogens11101209.
• 63 Anderson J, Schiffer C, Lee SK. et al. Viral protease inhibitors. Handb Exp Pharmacol 2009; 189: 85-110 DOI: 10.1007/978-3-540-79086-0_4.
• 64 Kim Y, Lovell S, Tiew KC. et al. Broad-spectrum antivirals against 3C or 3C-like proteases of picornaviruses, noroviruses, and coronaviruses. J Virol 2012; 86: 11754-11762 DOI: 10.1128/jvi.01348-12.
• 65 Pedersen NC, Kim Y, Liu H. et al. Efficacy of a 3C-like protease inhibitor in treating various forms of acquired feline infectious peritonitis. J Feline Med Surg 2018; 20: 378-392 DOI: 10.1177/1098612x17729626.
• 66 Ziebuhr J, Snijder EJ, Gorbalenya AE. Virus-encoded proteinases and proteolytic processing in the Nidovirales. J Gen Virol 2000; 81: 853-879 DOI: 10.1099/0022-1317-81-4-853.
• 67 Green K. Caliciviruses: the noroviruses.In: Knipe DM, Howley PM, Griffin DE, Lamb RA, Martin MA, Roizman B, Straus SE, Hrsg. Fields virology. 5. Aufl. Lippincott Williams & Wilkins; 2007: 82-608
• 68 Kim Y, Liu H, Galasiti Kankanamalage AC. et al. Reversal of the progression of fatal coronavirus infection in cats by a broad-spectrum coronavirus protease inhibitor. PLoS Pathog 2016; 12: e1005531 DOI: 10.1371/journal.ppat.1005531.
• 69 Perera KD, Rathnayake AD, Liu H. et al. Characterization of amino acid substitutions in feline coronavirus 3C-like protease from a cat with feline infectious peritonitis treated with a protease inhibitor. Vet Microbiol 2019; 237: 108398 DOI: 10.1016/j.vetmic.2019.108398.
• 70 Jiao Z, Yan Y, Chen Y. et al. Adaptive mutation in the main protease cleavage site of feline coronavirus renders the virus more resistant to main protease inhibitors. J Virol 2022; 96: e0090722 DOI: 10.1128/jvi.00907-22.
• 71 Xie J, Wang Z. Can remdesivir and its parent nucleoside GS-441524 be potential oral drugs? An in vitro and in vivo DMPK assessment. Acta Pharm Sin B 2021; 11: 1607-1616 DOI: 10.1016/j.apsb.2021.03.028.
• 72 Ansems K, Grundeis F, Dahms K. et al. Remdesivir for the treatment of COVID-19. Cochrane Database Syst Rev 2021; 8: Cd014962 DOI: 10.1002/14651858.Cd014962.
• 73 Anonym. “Cat treated with remdesivir for feline infectious peritonitis.” Vet. Rec 190: 231-231 https://doi.org/10.1002/vetr.1592
• 74 Bohm M. Successful treatment of a South African cat with effusive feline infectious peritonitis with remdesivir. J S Afr Vet Assoc 2022; 93: 112-115 DOI: 10.36303/jsava.238.
• 75 WalkervilleVet. Treatment with remdesivir for FIP in cats (November 2020). Im Internet: https://www.walkervillevet.com.au/blog/fip-cat-treatment-remdesivir/. Stand 07.02.2023
• 76 Coggins SJ, Norris JM, Malik R. et al. Feline infectious peritonitis treatment with compounded parenteral remdesivir and/or oral GS-442524. 6. Kongress der International Society for Companion Animal Infectious Diseases (ISCAID); Glasgow. 2022
• 77 Green J, Syme H, Tayler S. A case series of 25 cats with effusive and non-effusive feline infectious peritonitis treated with a combination of remdesivir and GS-441524. 32. ECVIM-Kongress, Göteborg. 2022 https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.16559
• 78 European Medicine Agency (EMA). Veklury (Zusammenfassung der Merkmale des Arzneimittels). Im Internet: https://www.ema.europa.eu/en/documents/product-information/veklury-epar-product-information_de.pdf. Stand: 07.02.2023
• 79 Weber S, Holicki C, Krentz D. et al. One to beat them all? Efficacy of a multi-component drug containing GS-441524 against feline coronavirus and SARS-CoV-2. 14th EPIZONE Annual Meeting, Barcelona. 2022
• 80 Murphy BG, Perron M, Murakami E. et al. The nucleoside analog GS-441524 strongly inhibits feline infectious peritonitis (FIP) virus in tissue culture and experimental cat infection studies. Vet Microbiol 2018; 219: 226-233 DOI: 10.1016/j.vetmic.2018.04.026.
• 81 Cho A, Saunders OL, Butler T. et al. Synthesis and antiviral activity of a series of 1’-substituted 4-aza-7,9-dideazaadenosine C-nucleosides. Bioorg Med Chem Lett 2012; 22: 2705-2707 DOI: 10.1016/j.bmcl.2012.02.105.
• 82 Amirian ES, Levy JK. Current knowledge about the antivirals remdesivir (GS-5734) and GS-441524 as therapeutic options for coronaviruses. One Health 2020; 9: 100128 DOI: 10.1016/j.onehlt.2020.100128.
• 83 Krentz D, Zenger K, Alberer M. et al. Curing cats with feline onfectious peritonitis with an oral multi-component drug containing GS-441524. Viruses 2021; 13: 2228 10.3390/v13112228
• 84 Jones S, Novicoff W, Nadeau J. et al. Unlicensed GS-441524-like antiviral therapy can be effective for at-home treatment of feline infectious peritonitis. Animals 2021; 11: 2257 10.3390/ani11082257
• 85 Yin Y, Li T, Wang C. et al. A retrospective study of clinical and laboratory features and treatment on cats highly suspected of feline infectious peritonitis in Wuhan, China. Sci Rep 2021; 11: 5208 DOI: 10.1038/s41598-021-84754-0.
• 86 Katayama M, Uemura Y. Therapeutic effects of Mutian^® Xraphconn on 141 client-owned cats with feline infectious peritonitis predicted by total bilirubin levels. Vet Sci 2021; 8: 328 10.3390/vetsci8120328
• 87 Addie DD, Silveira C, Aston C. et al. Alpha-1 acid glycoprotein reduction differentiated recovery from remission in a small cohort of cats treated for feline infectious peritonitis. Viruses 2022; 14: 744 10.3390/v14040744
• 88 Pedersen NC, Perron M, Bannasch M. et al. Efficacy and safety of the nucleoside analog GS-441524 for treatment of cats with naturally occurring feline infectious peritonitis. J Feline Med Surg 2019; 21: 271-281 DOI: 10.1177/1098612x19825701.
• 89 Dickinson PJ, Bannasch M, Thomasy SM. et al. Antiviral treatment using the adenosine nucleoside analogue GS-441524 in cats with clinically diagnosed neurological feline infectious peritonitis. J Vet Intern Med 2020; 34: 1587-1593 10.1111/jvim.15780
• 90 Mateos González M, Sierra Gonzalo E, Casado Lopez I. et al. The prognostic value of eosinophil recovery in COVID-19: a multicentre, retrospective cohort study on patients hospitalised in spanish hospitals. J Clin Med 2021; 10: 305 10.3390/jcm10020305
• 91 Krentz D, Zwicklbauer K, Felten S. et al. Clinical follow-up and postmortem findings in a cat that was cured of feline infectious peritonitis with an oral antiviral drug containing GS-441524. Viruses 2022; 14: 2040 10.3390/v14092040
• 92 Zwicklbauer K, Krentz D, Bergmann M, et al. Long-term follow-up of cats in complete remission after treatment of feline infectious peritonitis with oral GS-441524. J Feline Med Surg 2023; DOI: 25: 1098612x231183250.
• 93 Lv J, Bai Y, Wang Y. et al. Effect of GS-441524 in combination with the 3C-like protease inhibitor GC376 on the treatment of naturally transmitted feline infectious peritonitis. Front Vet Sci 2022; 9: 1002488 10.3389/fvets.2022.1002488
• 94 Addie DD, Curran S, Bellini F. et al. Oral Mutian^®X stopped faecal feline coronavirus shedding by naturally infected cats. Res Vet Sci 2020; 130: 222-229 DOI: 10.1016/j.rvsc.2020.02.012.
• 95 Klein-Richers U, Hartmann K, Hofmann-Lehmann R. et al. Prevalence of feline coronavirus shedding in german catteries and associated risk factors. Viruses. 2020 12. 10.3390/v12091000
• 96 Meli ML, Spiri AM, Zwicklbauer K. et al. Fecal feline coronavirus RNA shedding and spike gene mutations in cats with feline infectious peritonitis treated with GS-441524. Viruses 2022; 14: 1069 10.3390/v14051069