Molnupiravir treatment of 18 cats with feline infectious peritonitis: A case series

J Vet Intern Med. 2023 Sep-Oct;37(5):1876-1880. doi: 10.1111/jvim.16832. Epub 2023 Aug 8.

Abstract

Background: Feline infectious peritonitis (FIP) is a viral disease in cats, caused by certain strains of coronavirus and has a high case fatality rate.

Objective: This case series reports the outcomes of treatment of cats with FIP using molnupiravir.

Animals: Eighteen cats diagnosed with FIP at the You-Me Animal Clinic, Sakura-shi, Japan between January and August 2022, and whose owners gave informed consent to this experimental treatment.

Methods: For this prospective observational study, molnupiravir tablets were compounded in-house at the You-Me Animal Clinic. Owners administered 10-20 mg/kg PO twice daily. Standard treatment duration was 84 days.

Results: Among 18 cats, 13 cats had effusive FIP and 5 had noneffusive FIP. Three cats had neurological or ocular signs of FIP before treatment. Four cats, all with effusive FIP, died or were euthanized within 7 days of starting treatment. The remaining 14 cats completed treatment and remained in remission at the time of writing (139-206 days after starting treatment). Elevated serum alanine transaminase (ALT) activity was found in 3 cats, all at Days 7-9, and all recovered without management. Two cats with jaundice were hospitalized, 1 during treatment (Day 37) and 1 with severe anemia at the start of treatment.

Conclusions and clinical importance: This case series suggests that molnupiravir might be an effective and safe treatment for domestic cats with FIP at a dose of 10-20 mg/kg twice daily.

Keywords: FIP; antiviral; outcomes; treatment.

Publication types

  • Observational Study
  • Observational Study, Veterinary
  • Case Reports

MeSH terms

  • Animals
  • Cat Diseases* / drug therapy
  • Cats
  • Coronavirus Infections* / veterinary
  • Coronavirus, Feline*
  • Cytidine / analogs & derivatives
  • Feline Infectious Peritonitis* / drug therapy
  • Hydroxylamines
  • Virus Diseases* / veterinary

Substances

  • molnupiravir
  • Cytidine
  • Hydroxylamines

Grants and funding