Treatment With Remdesivir Alone or in Combination With GS-441524 in Cats With Ocular Involvement of Feline Infectious Peritonitis: An Observational Case Series.

BACKGROUND: Remdesivir and GS-441524 have successfully treated cats with feline infectious peritonitis (FIP) but the changes in associated signs of ocular disease are not reported. OBJECTIVE: Evaluate the response of FIP-associated signs of ocular disease before and after treatment with remdesivir, GS-441524, or both. ANIMALS: Sixty-one cats diagnosed with FIP by the Internal Medicine services between October 2021 and December 2022 that were treated with injectable, oral, or a combination of anti-viral therapies were reviewed. METHODS: Observation study. Signalment, associated signs of ocular disease, treatment, outcome, and follow-up of affected cats were analyzed. RESULTS: Associated signs of ocular disease in cats with FIP were diagnosed in 33% (20/61) cats, with a median follow-up of 55 days (IQR 47.3-90.8, range: 16-1071 days) in 11 cats with FIP. Ocular changes were all associated with uveitis, of which 20% (4/20) had anterior uveitis, 25% (5/20) had posterior uveitis, and 55% (11/20) had panuveitis. Ocular disease occurred in effusive (11/20; 55%) and non-effusive (9/20; 45%) FIP and was bilateral in 70% (14/20) cats. All cats started an 84-day course of treatment, with the majority (17/20; 85%) receiving remdesivir in the initial period. Of those, 70% (12/17) received a high dose of 15-20 mg/kg/day. Eleven cats with uveitis had long-term follow-up nine (9/11; 82%) of these had resolution of uveitis. Eighty-seven percent (13/15) of cases with anterior uveitis received topical anti-inflammatory medication. Eighty percent (16/20) of cats survived. CONCLUSION AND CLINICAL IMPORTANCE: Cats with FIP commonly have ocular involvement. Associated uveitis responded to remdesivir or GS-441524 treatment effectively in 82% of cases.