In February of 2009, a revolutionary new drug called Lymphocyte T-Cell Immunomodulator was approved by the FDA for use in felines. Imulan BioTherapeutics conducted the initial field trials, publishing studies outlining the effectiveness of LTCI in treating feline leukemia and FIV. Imulan also conducted an unpublished study on the effectiveness of LTCI in treating Feline Infectious Peritonitus. Six of the cats at Healing Hearts Animal Rescue in Nashville participated in this study.
Throughout 2009, Healing Hearts treated a total of 15 cats with FIP using LTCI as the primary method of treatment. The treatment group ranged in age from 10 months to 6 years in age. All of the cats were living together in the same foster home, sharing food dishes and litter pans. 13 of the cats had mild to moderate symptoms at the time that they began treatment. Only Star and Cinder experienced severe symptoms before or during treatment. By December 2009, all fifteen cats tested completely negative for the Corona virus after completing treatment with LTCI.
New Research on LTCI
In the years since then, many questions have been raised as to why LTCI worked so dramatically for the Healing Hearts cats yet has had mixed results with other cats. New research has shown that with LTCI and the severe illnesses it is used to treat, there is a certain point beyond which the patient's body is too badly damaged for LTCI to help. Once a cat's body reaches this "point of no return", not even LTCI is enough to save the patient.
Serengeti, the original cat diagnosed with FIP at Healing Hearts, is a good example of a cat who would not likely have been saved with LTCI. By the time we realized he was sick and were able to get him to the vet for testing, he was already anemic, severely dehydrated, and in kidney failure, as well as suffering from low protein levels. Euthanasia was the kindest option for poor Serengeti, where his diagnosis of dry FIP was confirmed through autopsy.
However, because Serengeti made Healing Hearts aware of the symptoms of dry FIP, when Litah, our therapy cat, began showing signs of vomiting mucus and losing weight, she was able to get testing and treatment much earlier in the course of the illness. When Litah began taking LTCI she was just beginning to show signs of anemia, had not eaten in 6 days, and tested moderately high (1:80) on a Corona titer test. She came home from that first LTCI shot and began eating dry food immediately. Within 6 LTCI shots, Litah was completely negative for Corona virus and remains healthy and active to this day, even at nine years old.
A Definitive Diagnosis
Before selecting a treatment option, it is important to make sure that your cat has Feline Infectious Peritonitus and not some other medical condition. Most veterinarians are general practitioners and may not be aware of the specific tests needed for a clear diagnosis of FIP. For example, a swollen stomach may indicate wet FIP, but it can also indicate other conditions like pregnancy. Never euthanize a cat with a swollen stomach on the assumption that it is FIP without further testing.
In 2010, Healing Hearts rescued a small grey tabby cat with a swollen stomach from a feral colony in Old Hickory, TN. Under anesthesia, we learned that Namendi was not a pregnant female or a cat with FIP, but in fact an under-developed FIV-positive male with a bite wound in his side that had become infected, creating the large, fluid-filled swelling in his stomach. This is an example of another medical condition that can mimic FIP.
For a cat with a swollen stomach, the quickest test for wet FIP is the Rivalta test. The test involves your veterinarian withdrawing a small amount of fluid from the swelling in your cat's stomach and releasing one drop into a mixture of 10 ml of water and 2 drops of white vinegar. For interpretation of the results, see Dr. Addie's site.
Dry FIP is more complicated to diagnose because the primary symptoms are sudden, unexplained loss of appetite and weight loss, sometimes accompanied by fever. One of the reasons that FIP progresses so rapidly is because the patient loses all interest in eating. This eventually causes symptoms such as anemia, dehydration and eventually kidney failure and death.
Whenever your cat stops eating suddenly and begins to lose a dramatic amount of weight, a trip to the vet and some thorough testing is in order. If dry FIP is suspected these are the key blood tests to run:
•FIP titer test - positive results indicate exposure to the Corona virus. A positive cat may have FIP, if symptoms and abnormal protein levels are also present. A negative cat does not have FIP, unless it is near death.
•CBC or Complete Blood Count - offers a brief snapshot of your cat's overall health, including white blood cell count and anemia. A cat with a normal CBC is unlikely to have FIP.
•Protein panel - abnormally high or low protein levels usually indicate the presence of FIP. The key indicators are albumin and globulin and if possible, the A/G ratio.
High Potential Patients
Cats with these symptoms or conditions have a high potential for LTCI to provide a dramatic decrease in or elimination of symptoms. Cats at this stage have good potential for eventually testing negative for the Corona virus with continued administration of LTCI.
•Diagnosis of dry FIP
•Diarrhea
•Loss of Appetite
•Weight Loss
•Fever
•Depression
•Lethargia
At Healing Hearts, most of the cats that we treated fell into this category. Being aware of the symptoms of dry FIP helped us catch Litah, Blaze, Alanya, Simba, Dash, Coal, Calla, Kori, Whisper, Thyme, Alexandra, Halle, and Aranelle in the early stages of their illness. They experienced all of the above symptoms.
Low Potential Patients
Cats with these symptoms or conditions have a low potential for LTCI to be an effective treatment. LTCI may provide some alleviation of symptoms but is unlikely to make a dramatic difference in the course of treatment.
•Diagnosis of wet FIP
•Very high or very low protein levels
•Stomach swollen with fluid
•Current treatment with steroid medication such as prednisolone
•Kidney failure
•Kittens under six months of age
•Senior cats with other health problems
•Co-occuring diagnosis of feline leukemia or FIV
•Neurological issues such as confusion, weakness, difficulty standing or walking
At Healing Hearts, we treated two cats who fell into this category: Cinder and Star, a pair of Siamese mix brothers. Cinder became sick with FIP a full month before LTCI was available. In January 2009 he tested at an FIP titer level of 1:10,000. At that time he received a Convenia shot which gave him some renewed energy and strength. However, he was unable to eat dry food or canned food, surviving on only a handful of treats twice a day. By February, this once-muscular cat had become a walking skeleton who could barely stumble around the house.
Because he was in such poor condition, it took longer for LTCI to make a dramatic difference for Cinder. After his first shot, he began eating small amounts of dry food. After three shots over the course of three weeks, Cinder had returned to normal eating and was beginning to gain a noticeable amount of weight back. When restested after his sixth shot, Cinder's titer level had gone down to 1:80. After six months and eight shots, Cinder tested negative for FIP and remains healthy, active and symptom-free.
Star began his LTCI treatment much like his friends, with a moderate titer level of 1:80 and mild symptoms. However, after the fourth LTCI shot, when the others were moved to monthly shots, Star suffered a severe relapse after only two weeks without LTCI. He became so weak that he could not walk or jump and had difficulty standing. So Star was placed on weekly LTCI shots. Even so, his titer level rose to 1:160. Each week he would come home from his LTCI shot bouncing off the walls with energy and happily gobbling down dry food. But by the end of the week he would be lethargic and struggling again to eat. Gradually his energy stayed with him for longer time periods and eventually after 21 LTCI shots, Star also tested negative for FIP. He remains healthy, active and symptom-free as well.
Side Effects and Safety Issues
Through a group of studies with several different species, LTCI has never shown any adverse reaction in any feline, canine or equine patient. LTCI is administered through a small injection the same size as a rabies or distemper vaccination. LTCI is no more painful to the feline patient than a routine rabies vaccination or antibiotic shot.
More Information On LTCI
Lymphocyte T-Cell Immunomodulator is currently being produced only by T-Cyte Therapeutics. In the United States, LTCI is only available through a licensed veterinarian. Tcyte is not permitted to sell their product to private owners or organizations. The fastest way to start treating your cat with LTCI is to find a local veterinarian who already stocks LTCI for their patients.
The only limitation of using LTCI is the exorbitant cost of this product. So make sure that your cat has FIP and that you are committed to trying at least the first three baseline shots before you order it. The standard treatment regimen begins with three weekly shots followed by bi-weekly or monthly shots as needed. It can be given weekly as long as necessary in more severe cases.
Finding a Veterinarian to Help You
T-Cyte Therapeutics offers a link where you can enter your zip code and be provided with a list of every veterinary clinic within a 50 mile radius that offers LTCI as a treatment option. Just review your list of options and call the closest clinics to compare prices and treatment options. Some clinics may offer a reduced price if you purchase a multi-pak of 3 or 10 LTCI shots.
If your regular veterinarian is not willing to order LTCI, consider trying a new clinic who is already ordering LTCI for their clients. Bloodwork and test results can easily be faxed from one clinic to another and there is no time to lose when trying to save the life of a cat with FIP.
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