Kristiina (00:33)
Welcome to another episode of Hiss and Tell. I am your host, Kristiina Wilson. And with me again today is the lovely Dr. Gina Rendon of Williamsburg Vets. Yay. I don't know why I always clap when you're on. I always clap. I'm such a moron. Okay. Today's topic is FIP, which is feline infectious peritonitis. I don't know a whole lot about this topic, which is why Dr. Rendon is here to tell us all about it.
Gina Rendon (00:43)
Yay!
Mm -hmm.
Kristiina (00:59)
So let's just kick off, Dr. Rendon. What is FIP? Tell us all about it.
Gina Rendon (01:02)
Yes.
Well, the reason that we're doing this podcast, I'd like to say is that the last one that we did together, somebody had a question about FIP and there are so many things happening with FIP that I did feel like it was worth it to do a whole podcast to talk about how things are changing. But so FIP, feline infectious peritonitis is actually it's a coronavirus, which I think we should all be very familiar with because of COVID.
Um, they're not the same, um, they're, they're distantly related. So people don't have to worry about any kind of, transferal from cats to humans and humans, a cat set. That's that's a different thing. But, um, so the interesting thing about FIP is that it actually is a mutation of a much more common coronavirus
It's feline coronavirus, but it's something that actually usually affects their gut. And it's something that is ubiquitous. You see it everywhere. It's very common. It's most common in groups of cats, so multiple cat households, rescue places, shelters, catteries, you know, that type of a thing. And it's passed through the gut. It's a fecal -oral transmission, which means this is a virus that lives in cells in the gut.
Kristiina (01:55)
Right.
Mm -hmm.
Gina Rendon (02:21)
And then when cats have it, if they are shedding and then they're cleaning themselves, or if a mother cat is cleaning, you know, if they're cleaning each other, aloe grooming, then it can get passed around. So very, very common. Rarely does it cause any major issues. You know, sometimes you'll have a kitten that has diarrhea, but it tends to be something that they can clear pretty effectively. It's interesting because it's something that they can clear and then get reinfected and clear and get reinfected. And so.
Kind of like with COVID, it's something that's out there and it changes a lot. So FIP is that virus that then within the animal, and we don't know why, it can mutate into something that's much more virulent. And so where it originally is a virus that lives in the gut cells, it then changes and becomes much more.
Kristiina (03:06)
Mm -hmm.
Gina Rendon (03:14)
friendly to cells that are white blood cells. And so monocytes and macrophages, it'll start to invade those cells and those are white blood cells that grow through the entire body. And so then it can become a systemic illness and that is a very virulent disease and it's just, it's tragic. So cats that are most at risk are cats that are from multi -cat groups. So again, what I was describing.
Kristiina (03:17)
rape.
Mm -hmm.
Gina Rendon (03:40)
the youngest cats are the most susceptible to having the initial, the more benign version. And there's a possibility that the cats that have been exposed the most as kittens may be more at risk for developing it later. But it's something that you can't really predict if it's going to happen. Once it does happen, it can affect any part of the body.
And so that's the part that gets a little bit hard. Um, and it's been around for, I think it was first recognized like in the sixties or something like that, but every veterinarian who has worked with cats has seen FIP and it used to be deadly, you know, cats would die from it and it was just incredibly depressing. So, um, young cats, usually less than two years old, it affects male cats more. It affects, um, purebreds more.
Kristiina (04:22)
Right.
Gina Rendon (04:37)
And then if they've been in a situation where they've been around a lot of other cats, And there is evidence that stressful events can make this more likely to be, um, to, to mutate. And so with, you know, cats and stress, I think that's a whole new, you know, podcast,
Kristiina (04:41)
Right.
Yeah,
Gina Rendon (04:53)
there are a lot of potential things that can act as stressors and triggers, but, once it has mutated, then, um, then it's a big deal. Um, I'm going to let you ask questions as we go. Cause otherwise I'm just going to yammer and, and just keep talking. Yeah, anything.
Kristiina (05:07)
No, I mean, you're not, you're not yammering. You're the one who knows stuff. I don't know anything about this and I'm just going to ask dumb questions, you know? So please continue.
Gina Rendon (05:15)
Okay, okay. Okay. So, um, the common presentation for cats that have FIP, um, usually it'll be a young cat that comes in and is sick. And it can be that they're lethargic, that they're not eating. They can have a fever. Um, and when I was preparing for this, I was actually thinking about Eugene because, um, you know, Eugene is one of your babies who had a
Kristiina (05:39)
Right.
Gina Rendon (05:42)
terrible fever. And so not every fever is FIP and young cats can have viruses that will cause fever. Cats are really good at doing fevers and so they can have really high fevers. FIP is not one that you necessarily will see really high fevers with, but it is one of the things that they can get. There are classic presentations of FIP that are easy to diagnose or just a little bit more what you would expect for FIP.
Kristiina (05:46)
Right.
Gina Rendon (06:10)
And those symptoms would be, um, they often develop fluid in their abdomen. So something called effusion Um, they can have the fever blood work changes. Usually they'll have elevations in globulin levels, um, liver values, uh, cats can come in jaundice, so they can be a little bit yellow looking. And so for those cases, if you look at, you know, what, you know, the age of the cat, the type of cat, and you have those particular symptoms, then it's pretty.
Um, clear that it's FIP. Um, but FIP can look really like anything. So that's the hard part, since it is something that has, that virus has an affinity for these white blood cells. It can go to any part of the body. Unfortunately, there's not one single test that will diagnose FIP. Yeah. And so, um, it can be really hard. Like I said, there are those classic presentations, which I think every vet has seen. Um, and.
Kristiina (06:56)
Right, that's what I was gonna ask, yeah.
Gina Rendon (07:08)
And unfortunately for a very long time, like up until five years ago, if you diagnose that, then those cats would die, which is absolutely devastating. And so one of the reasons that I wanted to talk about this is that like within the last five to six years, there are treatments that are available, which is, you know, we'll talk about that more in a little bit. And so now we are seeing really amazing success rates with treatment.
Kristiina (07:36)
Right.
Gina Rendon (07:36)
Um, but so going back to that whole testing question, um, when you don't have a classic presentation, then it can be really hard to diagnose FIP and it can look like a bunch of other things that can look like, you know, gastroenteritis. It can look like, um, fungal disease. Uh, it can look like toxoplasma. So there are a bunch of different other things that it can potentially mimic. Um,
The American Association of Feline Practitioners, which I am a member and I believe that you do a lot of there. Yeah. Yes. We love very much and is an excellent resource for, um, for cat owners and for vets. Uh, they, and another group called Every Cat, um, which is a nonprofit foundation. They, they actually do a lot of funding for research, um, and is also an amazing resource. The two of them put together guidelines for veterinarians on how to diagnose FIP.
Kristiina (08:07)
Me too. Yes.
Mm -hmm.
Gina Rendon (08:32)
And one of the things that's a little bit depressing is that they created these, um, guidelines and with FIP, the diagnosis, the way they call it is it's brick by brick. So there's not that one test. You have to take this test and that test and this test and that test, and you have to form a picture that, um, gives you a sense, is this FIP or is this something else? And so.
Kristiina (08:45)
Mm -hmm.
Right.
Gina Rendon (08:58)
Um, it can be really challenging. And what I would recommend is if you have a cat that sick and you're having a really hard time, um, coming up with a diagnosis, then, um, make sure that your vet does, you know, have those guidelines because they are free and available for every, every vet. Um, and really understand what it might take to be able to diagnose. Cause it can be very frustrating for those cases that are really unusual, but,
I think that's one of the hard parts about FIP is that it really can look like everything. And, you know, again, I'd like to reiterate that not every fever is FIP. There are a lot of cats that can get fever and, you know, you treat them and they go on and they do great. So that's important to know.
Kristiina (09:29)
Right.
Yeah. Yeah. I mean, in my own experience, thankfully, I've never seen a case of FIP, which I can't believe in all these years of working with cats. But I have seen, as you know, I've seen many, many cases of incredibly high fevers, like 107, which is super high for anyone. And then it ends up being a form of Calici usually walking Calici or limping Calici, not walking Calici, limping Calici, but some form of Calici virus, which has given many cats.
Gina Rendon (09:46)
I know that's amazing. Yeah.
Mm -hmm. Right. Crazy. Yep.
Right. Yep. Yep.
Kristiina (10:07)
crazy high fever and gotten them a hospital stay. So that's very true. I feel like I read something in doing research for this episode about PCR testing that is relatively new, but possibly not super reliable.
Gina Rendon (10:08)
Mm -hmm.
Yeah. Yeah.
Mm -hmm. Mm -hmm.
Right. So if you do have a cat that has a fever, it is a good idea to do an infectious disease panel. So looking for things like have they been exposed to coronavirus, which is not diagnostic, but it tells you whether that's a possibility. And so a good example is we have a kitten that we saw recently that had a fever and was negative for coronavirus that rules out FIP is the cause of this fever. So that's, you know,
Kristiina (10:27)
Mm -hmm.
Right.
Gina Rendon (10:50)
fabulous if you get those results, that's really great. But you're also looking for those other diseases, so feline leukemia, FIV, toxo, and basically just trying to put together a picture. The PCR tests, unfortunately, you have to have the right sample for them. And so if you can get effusion, if you can get that fluid that's...
Kristiina (10:51)
Thank you.
Gina Rendon (11:18)
building up in places where it shouldn't be, then you can do PCR on those. They're not perfect tests. There are labs that are working on testing. And so I think right now, Kansas State University, there are vets there that are working really hard on developing tests that, like one test that you can do that says this is FIP or not. But right now it really is trying to get a full picture.
Kristiina (11:23)
Sure.
Right.
Gina Rendon (11:44)
And unfortunately, the only way you can confirm FIP is post -mortem, which you don't want to have to do that, obviously. Yeah, exactly.
Kristiina (11:51)
You don't want to do. I have another question and this, this is probably just a dumb question, but if you have a cat, let's say like Mimi, who has his immunocompromised, who has like a not good immune system and you want to do the PCR test is there a chance of them popping negative on the test for coronavirus because they're not able to build a robust immune response?
Gina Rendon (12:02)
Okay.
Yeah. That's actually not a dumb question because I don't know the answer. I mean, I guess if it's negative for coronavirus, then she doesn't have FIP. I guess that's the answer. But FIP is not like herpes that you live with it forever. And so...
Kristiina (12:22)
Well, we're both idiots.
Right.
Right.
Gina Rendon (12:39)
So, you know, if it comes back negative, it's going to be negative. I guess that would be my answer. Yeah. Yeah.
Kristiina (12:44)
Okay. So they're not testing. This is my ignorance about how these tests work. They're not testing your body's immune response to say whether or not you've had it. Okay. Okay. That's what I was wondering. Okay.
Gina Rendon (12:48)
Mm -hmm.
Right, that's right. Yeah, yeah, yeah, yeah. So it's not, it's not like titers for that. Yeah.
Kristiina (13:02)
Got it. Okay. Thank you. Um, but kind of piggybacking off that, that question, and then I'll, I'll let you get back to, um, just going on your, your very excellent and smart rants about FIP. Um, that's what we'll call this episode. It's just ranting about FIP.
Gina Rendon (13:11)
Thank you.
Hahaha.
Kristiina (13:18)
Right, so my other question was you have talked about it really being a disease that we see a lot in younger cats. Is it a disease that you have seen in older cats and that?
Gina Rendon (13:24)
Okay.
Older cats can get affected as well. Yeah. So, so, and, and I think that's one of the things with, um, you know, there are populations that are most at risk, but, um, but there are other animals that will fall outside those risk categories. And so it is certainly something that you can see in older cats. Um, I have never seen a, you know, a mature cat, like a geriatric cat that has had FIP. And so when I say older cats, I'm still meaning, you know, young adulthood.
Kristiina (13:29)
Okay.
Mm -hmm.
Right.
Right.
Gina Rendon (13:57)
But usually after a certain period, I really haven't seen any old cats that get FIP.
Kristiina (14:04)
Okay, I think I'm always thinking with Mimi in mind, you know, our 13 year old medical mystery cat who just, yeah, medical miracle is really true.
Gina Rendon (14:07)
Mm -hmm.
A medical miracle, yes, who has lived well beyond all of our wildest expectations.
Kristiina (14:19)
And she's still, that's the reason I was late to this taping because she has developed a horrible habit of in the middle of the night, knocking everything off of our nightstands. And just cause she wants attention and it's, she's making us all insane. Cause she's just feeling so great. She's like, woo! Yeah, she's being a real B, let me tell you. But so my question was, yeah, is there...
Gina Rendon (14:22)
I don't know.
Uh -huh. Uh -huh.
It's, yeah, yeah. Good for her. Everybody get up. Yeah.
I'm gonna go.
Kristiina (14:47)
Is that a cause for concern at some point? Could a cat like Mimi who's 13 and has immune system problems and all these other comorbidities, is that something that I would also need to be concerned about? Or listeners would have to be concerned about in their geriatric cats. Okay. Okay. Okay. All right. Back to you and what you were saying.
Gina Rendon (14:51)
Mm -hmm.
Yeah.
No, no, I've never seen that, yeah.
Back to back to so we were talking about testing and how hard testing can be And now I want to talk a little bit about treatment, which is the really really exciting part oh I guess one of the things that's really important to say is that if a cat has that mutated form of FIP?
Kristiina (15:11)
Yes.
Okay.
Gina Rendon (15:24)
It is not transmissible. That FIP is not transmissible to other cats in the household. They can have coronavirus and it would have to mutate independently in each individual. So that's, I think, hopefully will make people feel better. Yeah, exactly. That if you have a cat with FIP, you don't have to take that cat out of the household. I mean, you know, the other cats are not going to get FIP from that cat. They could potentially get coronavirus from that cat. But.
Kristiina (15:34)
Got it. That's important.
Gina Rendon (15:54)
So, so it's kind of interesting. And the only reason I bring that up is because actually in Greece and Cyprus right now, you know, they have all those colonies of cats. Very recently there has been that particular thing of it not being infectious is, has changed. And so they're actually now seeing infectious FIP. Yeah. Which is, is really scary. So the, you know, there are cat researchers who are on top of that. And that's because Corona viruses, as we should all know.
Kristiina (16:03)
Mm -hmm.
Ohhhh
Gina Rendon (16:23)
they mutate and they do weird things. And so I think that's something that we should all probably be keeping a close eye on. But so that's in Greece. And so now we'll talk about treatment because that's, it's the most amazing thing. I didn't start hearing about treatment until about six years ago when somebody brought their Abyssinian in and we diagnosed the Abyssinian, a little beautiful kitty.
Kristiina (16:24)
Yeah.
Mm -hmm.
Gina Rendon (16:51)
with FIP, absolutely heartbreaking. And, um, and they did their research. They went online, you know, basically my understanding was that there was no treatment. There was, you know, this was a fatal disease and this was just tragic news that I had to pass to these owners. And they found a group, um, on Facebook that we're talking about treatment. So, um, a little bit of background, um, UC Davis, there's a lab and Neal's.
Peterson, Dr. Neils Peterson, who's a vet and a virologist, has a research lab at the, at the vet school there, has been doing research on antivirals in cats with FIP. And that's been going on for a while now. And so he was the first to show that antivirals actually do work on FIP. And so, in fact, I think one of the first medications that he was working with was Remdesivir. I think that's how, yeah.
Kristiina (17:46)
Oh yes, yes.
Gina Rendon (17:48)
which has been, is something that we use in COVID for humans. And then around the time, I think it was in the, in 2020, the FDA took that away from them because they needed to have emergency stock of it for treating humans with COVID. But that was one of the first, you know, really successful treatments. And so once his research started to get out there, people really, you know, common citizens, not veterinary, you know,
um, staff, not doctors, but just people who had cats who loved their cats and didn't want them to die, um, found each other and then found how to get these antivirals, uh, which is kind of amazing. So just to kind of go through them. So there's that one, which is one of the first ones. These all have letters. So, um, remdesivir is GS five seven three four. And the number is, I think they're all made by the same.
Kristiina (18:37)
Mm -hmm.
Gina Rendon (18:46)
company, so it's Gilead Sciences. And I think these are just the numbers of these antivirus that that's the company that has to develop these. And so when that became unavailable, the lab at UC Davis started to use something called GS 441524, which is the one that is the most available and the one that everybody has been using. And so these drugs, you know, besides the remdesivir, they were not
Kristiina (18:51)
Got it.
Gina Rendon (19:13)
FDA approved, they haven't been FDA approved. And so trying to get them has been challenging. Veterinarians are not allowed to prescribe them. They're not allowed to recommend them. That's against FDA regulations and you can lose your license if you try to prescribe them. And so people, common citizens, they did their workarounds and even though it wasn't being manufactured for release in the United States, people were finding places in China, India.
Kristiina (19:14)
Mm -hmm.
Mm -hmm.
Gina Rendon (19:43)
that we're making these antivirals and a whole black market developed and a whole network of volunteers and people who had to go through this developed ways to purchase this medication and make it available to owners to do treatment on their own basically, which is amazing. I mean, I think it's one of the best case scenarios for social media. You know, like everybody always.
complains about social media, but it really can do miraculous things. And that this is one of them. This is like the best possible thing. And so, um, if people are on Facebook, there's, um, FIP warriors. That's one of the ones that I was first introduced to. Uh, and if you have a cat that you want to start treatment with, you can contact them. They will link you with a volunteer who will then walk you through all the steps.
Kristiina (20:11)
Right.
Gina Rendon (20:39)
and help you with what you need to do, to do monitoring treatment, find dosing, find supply. And so, thousands of cats now have been treated and have lived. Whereas before it was a 99 .9 % death rate, now we're seeing something close to like a 90 % success rate with these medications, which is amazing. It's amazing. Not every animal.
Kristiina (20:59)
Right.
That's amazing.
Right.
Gina Rendon (21:07)
um, will survive. Some of them you can't take, take them off of the medications. Um, but they're out there and available. And one of the things that's actually really interesting is you hear black market, at least I hear black market and I'm like, Oh my God, like that sounds horrible. What are you going to get? You're going to get like flour and you're, you know, who knows? But, um, studies have shown that there have been people who've studied the, um, the supply chain and the medications, the antivirals are actually pretty pure.
Kristiina (21:22)
Mm -mm -mm. Right.
Mm -hmm.
Gina Rendon (21:37)
So the 44, 15, 24, which is the big one, all of the samples that were tested in one study were exactly that. And so it's kind of nice that, you know, that there has been, for one thing, people checking, doing quality checks, but also that it seems to be what, you know, they say it is.
Kristiina (21:58)
course.
Gina Rendon (22:03)
And so there are a couple of other antivirals too. So that's also important to know. Paxlova, everybody knows about Paxlova for COVID. That's actually a little bit too toxic for cats. And so that's not something that actually is available. But the 44, 15, 24, which is the most common, can be very effective.
Kristiina (22:11)
Mm -hmm.
Gina Rendon (22:26)
Um, it comes as both injectable. So initially I think all of these medications were just injectable. Uh, and I think, you know, the hard part about these is that, um, the medication itself is very acidic and they have to be injected and they can cause a lot of pain and they can cause skin issues. And so, um, you know, it becomes a, uh, benefits risk type of analysis of, you know, if you save your cat and it has.
Kristiina (22:31)
Mm -hmm.
Yeah.
Gina Rendon (22:54)
some skin lesions from time to time, you know, trying to decide what makes the most sense. And people who are treating their cats can go to their vets for follow -up. And so this is, again, you know, this is how I was introduced to all of this is having this, this person come with their cat and, and I would help with the blood work and I would help with, there were other, at that time we were doing other supplement type things and helping for them to, for them to order the supplements and.
Kristiina (22:58)
Right.
Mm -hmm.
Gina Rendon (23:23)
um, treating the skin issues when the skin issues arose, so things like that. So your vet is not completely useless in this, but they're, they're limited in what they can, what they can do. one of the questions I think that people ask, and I think this is the biggest question is why are these not FDA approved and why can't we use them and what's happening with that? So the most recent information is that.
Kristiina (23:27)
Right.
Yes.
Gina Rendon (23:50)
Gilead Sciences, they're not going in this direction. as far as we know, they're just really not interested in developing these into veterinary products and news sources that try to get them to comment. There's no comment. I think that one thing that I read is that they may be nervous about the possibility of adverse effects, which would then affect their ability to use it in humans.
Kristiina (24:18)
Hmm.
Gina Rendon (24:18)
So that's one possible theory. And so they kind of don't want to open up that can of worms. The remdesivir, which is FDA approved. So one of the things actually that's very interesting is now that it is no longer considered an emergency drug just for humans, it actually can be available for vets to use off label.
Kristiina (24:35)
Right.
Gina Rendon (24:40)
And so this is actually one of the things that I think is really interesting is that most vets don't even know that that's a possibility. And so, um, you know, for the most part, most vets just think there's nothing that I can prescribe. If you're able to get it, you can prescribe it as an off -label use that actually is FDA. Okay. Um, and, and so the veterinary, uh, information network bin is one of the new sources that, that, um, that's used.
Kristiina (24:54)
Mm -hmm.
Gina Rendon (25:08)
And they have an entire article about trying to make that better known among veterinarians. But it is still very hard to get your hands on because it is primarily only in human pharmacies and human pharmacists may not want to allow it to be scripted out by vets. So that's one of the challenges. Kansas State University is currently working on something.
Kristiina (25:30)
Right.
Gina Rendon (25:36)
which is a GC, it's not a GS. see, it is GC 376. And so they actually are working with a veterinary biotech company to get this license. And it's another antiviral that seems to have to show promise. And that is something that we're hoping by 2026 will be available. Yeah.
Kristiina (25:48)
Mm -hmm.
Amazing.
Gina Rendon (25:59)
Yeah. So there are things that are in the works, but you know, the most important thing, the thing that I think I hope is the takeaway is that if your cat has FIP, there are potentially options. Um, the injectable version of the, um, antiviral, there are also are also oral, versions. And so it's not always just injections. I think with the oral medication, there can be GI upset. So there's always like,
Kristiina (26:09)
Right.
Right. Decision. Yeah.
Gina Rendon (26:25)
you know, something, but decisions to make. And it may not be as effective, but for some cats, it makes a big difference. So yeah. Yeah. Yeah.
Kristiina (26:33)
Sure. Well, that's all great to hear, except for that that company is not interested in pursuing. That's frustrating.
Gina Rendon (26:40)
Yeah. Yeah. I mean, I, yeah, it's frustrating that there is not really even any statement by them. You know, they're not, they're just kind of like, we're staying out of this. Do what you will, but we're not, this is our thing. So, um, yeah, yeah, it's hard. It's hard, but you know, there are a lot of, um, there are a lot of groups out there that are still plugging away, doing the research.
Kristiina (26:46)
Yeah.
RUDE.
Gina Rendon (27:04)
working on testing, working on cures, and I'm really excited and confident that like within the next couple of years, there's going to be something available and we'll be able to see a much better outcome for these cats. I hope so.
Kristiina (27:18)
I hope so, but I think it's great that, like you said, that social media, that people are being so helpful. That reminds me kind of of how during the beginning of COVID, people on social media, at least in New York, were so helpful about finding, sourcing appointments for people for vaccinations, and it actually was being used in a good, kind way versus how it can often be used, yeah.
Gina Rendon (27:29)
Mm -hmm.
Mm -hmm. Mm -hmm.
Right. Yeah. No, there are definitely good people out there. Yeah. You know, and, and like -minded people who love their cats, know that relationship between humans and cats and how strong that is and want to help. So, yeah. Yeah. Which is great.
Kristiina (27:54)
Right.
So when cats are on this medication, I know you said some of them may have to be on it long -term. Is there like an average amount of time that cats generally have to be on medication, not? Oh, okay.
Gina Rendon (28:07)
It's usually, I believe 12 injections. And so, um, so it's usually 12 injections. There's dosing for the cats that don't respond initially to the first medication. And this is one of the interesting things is that the, um, remdesivir may be more effective. And so trying to get that available, you know, trying to get your vet to see if they can get ahold of it, um, can help to improve their outcome.
Um, but it's usually, you know, at that time. And I've seen cats that have had to use it for longer or had to adjust and go to a different antiviral. Um, the cost for this is around $5 ,000, $5 ,000 to $6 ,000 for getting the medication and treatment. And then I think that's just for the treatment. And, um, and then that doesn't include your, your testing and follow up in. Yeah. Yeah.
Kristiina (29:05)
Sure. Okay. Well, that was a very robust backstory on... Yes. Let me go through them. One of our listeners submitted questions and a lot of these came from listeners who actually have...
Gina Rendon (29:08)
You know.
Were there questions that, let's see.
Kristiina (29:25)
dealt with FIP in their cats successfully using the medications. And so they're just really curious about your take on a lot of this stuff. One of them is how do you feel about vaccinations in cats post FIP? And I assume they're talking about FVRCP rabies, the typical vaccinations that we're giving cats.
Gina Rendon (29:26)
Mm -hmm. Mm -hmm. Mm -hmm.
Right. Yeah. Yeah. During treatment, we don't recommend it for sure, because you want a really robust immune system, both for vaccines, but also for treating FIP. So I wouldn't recommend it. You could consider doing it for cats that are high risk for those things. So if you have an outdoor cat and there's the possibility that it could get rabies, you probably want to vaccinate it once it's in the clear.
Kristiina (29:55)
Mm -hmm.
Right.
Gina Rendon (30:12)
Um, if you have a cat that, and this is, I think true for a lot of cats, it kind of depends on the risk. Um, and, and there are guidelines again by AFP. Um, you know, if the risk is low for certain cats, I don't know that I would necessarily vaccinate, you know, if they're indoor only, they're not around any other cats, you know, nothing else is going on. Then you could consider, um, withholding vaccines, um, kind of depending on how they're doing.
Kristiina (30:41)
Are you seeing more cases of FIP about the same? What is your experience? Okay.
Gina Rendon (30:46)
About the same. Yeah, about the same. So definitely something that's not uncommon. You wish it were more uncommon, but you know, I would say several cases per year. But you know, the good news is that so many more of them are now post -treatment and that's like amazing. It's really amazing. Yeah.
Kristiina (31:04)
Right.
That is amazing. What are your feelings about there being some kind of trigger like stress? I mean, we kind of talked about this a little bit, but.
Gina Rendon (31:13)
That's been shown. We kind of talked about that. Yeah. Yeah. And so that is a factor. So that does seem to be something that the cats that do develop FIP, they have experienced stress. And I think that's a hard one because not everybody recognizes stress in cats. And cats are so sensitive that, you know, what you don't necessarily think of as stressful may be stressful. So, yeah. But yes, that is a factor.
Kristiina (31:33)
Mm -hmm.
Yes.
Okay. And stay tuned everyone for an upcoming episode with me and Gina on cats and stress. I really do think that that's, it's a really good topic and thanks for coming up with today's topic and the next topic. Um, you're, you're my unofficial producer, I think,
Gina Rendon (31:45)
Hahaha!
Oh, sure.
Yeah. Yeah. Well, the funny thing about cats, here's my opinion. Cats with stress, to me, like, and I think this is why it's so hard is because you see a cat that's curled up in a little ball in a, you know, in a beam of sun and you think what could be less stressful than the life of a cat. And, you know, when I was in vet school and working my...
Kristiina (32:00)
to talk about. Oh, yeah, sorry. OK, anyway.
Gina Rendon (32:20)
brains out and I would see my cat just sleeping away. I feel like, why are you living this life when I'm so stressed out? So I think that, you know, it's really easy to think that their life is so cushy and they've got it made and you know, you're basically their servant, but it's true. I think you'd be surprised about what can be stressful to a cat.
Kristiina (32:25)
Mm -hmm.
Oh, they're hypersensitive. They're really hypersensitive animals. And I think because they're predators and prey, that drives a lot of it. But I, well, we'll save that for our next episode. Getting into the nitty gritty of that. Cause I have a lot of thoughts on cats and stress also, and that driving a lot of disease and issues. Okay. So.
Gina Rendon (32:44)
so sensitive.
Mm -hmm. Yeah. Yeah.
Okay.
Yeah.
Mm -hmm. Yeah.
Kristiina (33:09)
Can my adult, oh, we talked about this, can my adult healthy cat come down with FIP at any time?
Gina Rendon (33:11)
Mm -hmm.
It's not likely. Yeah.
Kristiina (33:16)
Not likely. That's good.
Gina Rendon (33:18)
Well, yeah, you know, it's, it's the risk is low if it's otherwise been fine.
Kristiina (33:23)
So that wraps up our FIP related questions.
so one of our non -FIP related questions is can a cat with FIV live with other cats who don't have FIV without transmitting it? Is it safe? I can just say from my own experience having had several cats with FIV, first original Marvin who you may or may not have met, I don't know if you, I don't think you ever met her, but she was great. She was an NYC street cat who just walked into the house one day and never left. She had FIV and despite actually having a serious fight,
Gina Rendon (33:43)
I don't think I did.
Mm -hmm.
Kristiina (33:56)
with if you remember Emmi with one of our older cats did not transmit it and FIV is transmitted just like human HIV is transmitted right blood to blood contact saliva it's not really saliva but saliva yeah bites right yeah like a deep bite yes yeah so yes
Gina Rendon (33:59)
Oh yeah.
me.
Mm -hmm. Mm -hmm. Saliva. Yeah, yeah, so bites, bites. It has to be a bite, yeah. It's not from grooming, exactly. Yes, it has to be saliva to blood, yeah.
Kristiina (34:20)
So I was really concerned with that, but thankfully she never developed anything. And now we have Kevin, who is our big unit Kevin, and he has FIV and we have 10 other cats and we are not concerned at all. I mean, he has no teeth. So yeah, he's tooth optional because he did develop stomatitis because of the FIV.
Gina Rendon (34:23)
Yeah. Yep.
Uh -huh.
And he has no teeth as well. Because of the FIV, yes.
Kristiina (34:46)
But yeah, it's just not a concern for us. But perhaps you could speak to that a little bit just about the
Gina Rendon (34:49)
Right. Yeah. And so if you have a multicat household, um, and one of them turns out to be positive if they live in relative harmony, then the risk of, um, of them catching or passing on the disease is pretty low. So.
Um, it's not something that lasts in the environment and it does have to be bite to blood.
there is a vaccine available for feline leukemia and every young cat every cat or every kitten should start with a feline leukemia vaccine and then hopefully at some point it will become completely moot and we won't have to worry about it. Yeah.
Kristiina (35:16)
Mm -hmm.
All right, agreed, I haven't had a senior cat in years. What should I do, look for now that my baby is turning eight?
Gina Rendon (35:37)
Um, I'm going to say you have two more years before your cat is a senior. And they give you a little, a little more time. Exactly. We're going to push that back a little bit, but I, we talked about this at the last, in the last podcast is, um, you know, just making sure that you're monitoring for the usuals with your kitty, um, taking them in on a regular basis to see the vet having blood work done.
Kristiina (35:42)
Two more years before they get their AARP card. Yes.
Gina Rendon (36:04)
You know, monitoring for appetite, for their usual behavior, making sure there's no changes in their behavior. Yeah, all of the stuff we had talked about before.
Kristiina (36:14)
Okay, do they need to think about switching to a different food? I know there's always like a lot of marketing about like, oh, food for seniors. Is that something that people need to think about?
Gina Rendon (36:20)
Yeah. So food for seniors is actually not hugely different than food for adult mature cats. A lot of those foods will have, you know, extra like joint supplements or fatty acids or things like that, but the nutritional content is still the same. They can be calorie reduced for those cats that just become much less active. And so it's kind of depending on
on your cat's body weight. If your cat is a little bit heavy, then it might make sense to go ahead and switch over to to a mature geriatric food, but not necessarily. It just kind of depends. it's not, there are life, there are the age brackets for food. So kittens, there is a kitten food, and then it's not like there is a specific geriatric food guideline. Just.
Kristiina (37:07)
Right.
Gina Rendon (37:13)
you know, FYI, those foods are, it's like, um, kitten food and then adult food. So, yeah.
Kristiina (37:15)
Right.
Okay. And then sort of going along with that, what supplements have good evidence base for supporting joint health in older cats? I know the answer to this, but yes.
Gina Rendon (37:28)
And that's it. It's a good question because a lot of people don't know this. And I, you know, I learned this from, from continuing education. Cats don't really respond to glucosamine and chondroitin supplements the way dogs and humans do. And, you know, that's also somewhat variable, but cats respond much more to concentrated fatty acids. So the Marine fish oils and specifically to the green lipped mussel
So what I generally recommend for cats is Antinol which I believe you have your kitties on. Yes, yes.
Kristiina (37:59)
Yes, I sure do. And I have, again, Antinol's not sponsoring this. I wish somebody would. Yeah.
Gina Rendon (38:05)
Nope. And I don't get any money from Antinol either. But yeah, yeah, yeah. No one's, nope.
Kristiina (38:08)
Yeah, I'm sure we would both love to get money from places, but no one's giving us any money. No one's giving us money, but Antinol's amazing. You know, I gave it to Steve. He just, I noticed huge difference after like two to three weeks in the cats, the senior cats. When I started giving it to them, I started giving it to Mimi and she hadn't played in years and.
Gina Rendon (38:23)
Thank you. Thank you.
Thank you.
Kristiina (38:31)
she became insane and just started playing and running around and slapping people. It's like really being her old dominant self so I can't say enough good things about it. The only thing is that it is in a pill form which can be a bit rough for people. It's a capsule. It's a little capsule but...
Gina Rendon (38:33)
Uh huh.
I'm sorry.
Yeah.
Isn't it a capsule? Is it a little, and so, you know, you can, so, and I was going to say this because it's a little capsule with oil in it. So if you can't pill your cat, you can pierce the capsule and put the oil on the food, which is what I tell people. So yeah. And because it's not a, it's tiny, it's a tiny capsule. It's not a huge amount. And so it should be relatively easy to, um, hide that into food. If your cat is picky.
Kristiina (39:02)
Oh, okay. It is tiny.
I will say also it is very stinky because once it arrived smashed at our house, like it came in the mail and it was all smashed and I was like brrrr it was.
Gina Rendon (39:17)
It is super stinky. Mm -hmm. Uh -huh. Yeah, yeah, yeah.
Kristiina (39:24)
It was rough. It was a rough for a vegetarian. I was like, Hey, what, what is this? Um, thankfully the Kevin and Mimi are both good pill takers because they have to take so many pills every day anyway. Um, but.
Gina Rendon (39:28)
It's disgusting. Yeah, yeah.
Good.
Kristiina (39:36)
It's a great supplement. And I think for people who can't for some reason give that, like there is that super snoot green lipped mussel powder that you can sprinkle on stuff. And then I have noticed cats just love eating that. Um, it's a great, like little topper that I've used to put on food, especially when Mimi doesn't really want to eat, you know, cause she'll go through these periods of being inappetite. Um, and so that has also been good before we learned about Antinol. Um, that was a really good thing to, to use for, um, arthritis.
Gina Rendon (39:45)
Mm -hmm. Mm -hmm.
Mm -hmm.
Uh -huh.
Mm -hmm.
Kristiina (40:06)
cats for joints. please discuss dental work. Do water additives really help?
Gina Rendon (40:12)
So, um, they can help a little bit and it, and it depends on the water additive you're using. So to find the best products, the products that really do work, you should go to the veterinary oral health council website. So V O H C dot org. Um, it is a nonprofit group of, I don't know who they are. People who are interested in this kind of thing.
They evaluate all of the dental products on the market, veterinary dental products on the market and test to see which ones work and don't work. So they're not funded by any of these companies. It's, you know, it's an independent group, but they have product lists of all of the dental products that they think work. So, um, and, and they have, you know, it's a really excellent list. So vohc .org. so, you know, water additives do a little bit.
Kristiina (40:56)
Mm -hmm.
Gina Rendon (41:04)
Brushing is definitely the gold standard for dental care, but not everybody can brush their cat's teeth. It's really hard. And so it's really tough. It's a tall order. And the truth of the matter is that cats, unfortunately, get a lot of disease below the gum line. And so even brushing, you know, the treats, the foods, the various things that are out there for their teeth,
Kristiina (41:13)
No, that's tough. That's a tall order. Yeah.
Gina Rendon (41:32)
doing cleanings on a regular basis is definitely recommended. And the AAFP, again, back to our association, American Association of Feline Practitioners, they recommend that cats start having dentals by one year and have them yearly because there really is so much that's going on in the mouth that you can't detect unless you take x -rays, unless you're doing really thorough exams. So if you want to save those teeth or keep your cat as comfortable as possible, that would be the big recommendation.
Kristiina (41:53)
Right.
Gina Rendon (42:03)
interesting because there are cats that have stomatitis like Kevin, and then there are cats that just have gingivitis. And so the cats that have gingivitis doing dentals on a regular basis can make a big difference for saving those teeth. Some cats though, they just don't want to have teeth and you end up, you know, having to pull them all at some point anyway.
Kristiina (42:07)
Yes.
Yeah.
Right.
I know.
Gina Rendon (42:23)
And as you know, and this is a big, you know, most people don't realize this, cats do absolutely fine with no teeth. I think a lot of people are very nervous about the idea of their animals having extractions, but the pain that diseased teeth cause is not worth keeping those teeth in.
Kristiina (42:31)
Yes, they do.
Agreed. And I've talked to a lot of Steve's followers who write me because they know that, you know, Kevin and Mimi don't have teeth because they see them all the time with their open mouths and no teeth. And then they're saying, oh yeah, you know, I've, I've, I'm supposed to get all my cat's teeth extracted, but how do they, how do they eat? Blah, blah, blah. And they don't realize that cats don't actually chew very often that they're just throwing the food back. Yes.
Gina Rendon (42:53)
Yes.
Mm -hmm.
And especially when they have dental disease, I think people don't really realize they are not chewing with those teeth. And so over and over again, I have had clients that have been in shock and horror when I say, we need to take out all of these teeth. And then two weeks after the dental and those teeth are gone, they say, it is night and day. This cat is now happy. This cat who I thought was just a quiet,
Kristiina (43:13)
Mm -mm.
Yeah.
Gina Rendon (43:33)
You know, a little shy cat is now a brand new cat. And I hear it enough that I really believe in it.
Kristiina (43:37)
Right.
Well, and it can cause aggression too, right? So it doesn't, it doesn't always, yeah, the pain doesn't always just result in like a quiet cat. I will say in the case of Mimi, who's always been a little bit strident in her attitude, she was really before, you we found her, all her disease, she had stomatitis too, didn't she? You took out all her teeth. She just had bad teeth.
Gina Rendon (43:43)
Yeah, yeah, that pain, it's chronic pain, yeah.
Yeah, no, that's right.
Mm -hmm.
I think she just ended up having bad teeth. Yeah.
Kristiina (44:09)
Um, cause she was still quite young when we did it, but, um, she was, her attitude change within two weeks was also crazy, like crazy to see, you know, that she was nice to Ali finally. And it's like, didn't slap everyone in the face right away. You know, it really does make such a big difference. And I don't think, you know, again, I think we've talked about how cats hide pain really well, but I do think that.
Gina Rendon (44:11)
Yeah.
It's crazy. Yeah.
Uh huh, yeah, yeah.
Mm -hmm.
Kristiina (44:34)
Dental pain is such a big deal for them. I think for anybody, like if it's pain in your head, it's so hard to ignore. Like...
Gina Rendon (44:39)
Oh yeah, oh man, yeah, for sure, for sure, yeah, yeah, yeah.
Kristiina (44:43)
Yes, so I definitely agree with the yearly dentals. And to that end, people getting a good insurance plan that will cover that is really important because dentals are so expensive. And then once you start moving into extractions, and especially if you have multiple cats, it's very, very worth it. We just talked to one of our good friends through looking at different plans and explaining, well, you may need to do this down the line because their cat's a senior and definitely get a plan.
Gina Rendon (44:51)
Yes. Uh -huh.
Yeah, yeah.
Mm -hmm. Mm -hmm.
Mm -hmm.
Okay. Okay.
Kristiina (45:13)
that has dental included or at least extractions included. I think that's really important for people to do.
Gina Rendon (45:16)
We're hearing it.
And I think an additional comment is that it's good to do it before the dental disease is actually apparent. Because with insurance, with pet insurances, if they have a preexisting condition, they are not going to cover that. And so, yeah, exactly. So don't wait until your vet says that your cat needs extractions. You should do it before then so that it gets covered. Yeah.
Kristiina (45:27)
Oh, yes.
They won't cover it or they won't even take you. Yeah.
Yes, agreed, agreed. Okay, and the last question is when do you say it is enough meds? Let's say your cat is on six meds. Like how far do you take it with meds? And I can give my answer, but let's start with your answer, Gina.
Gina Rendon (46:02)
Yeah, you know, and you, when we had talked about this question, I think this is really hard because, um, especially later in life, when our kitties and our dogs, this is true for all animals. If they're getting older, it may be you have this pharmacy of medications that you're giving. My rule of thumb is, is it improving their life and improving their quality of life or.
Are you wrestling so much with giving these medications that that's ruining their life? Cause you'll have both, both cases. And so on an, it has to be an individual basis for each animal and you have to know your animal well enough to know what makes sense for them. So, um, you know, if they take their medications relatively well, if you're not stressing them out so much that they're hiding from you.
and you're seeing benefits from those medications, then there's not really a limit to how many you can give them. I know it gets really hard and you end up feeling like you have a hospice or you're this constant caretaker where you're doing all these things, but you really have to weigh the benefits with the cons of it. And if your cat tolerates it, and again, if you feel like they're benefiting, then to me it would be worth it. If your cat hates you,
and hates life and hates all of the, you know, the handling, you may end up feeling like it's not worth it to do understanding that your cat may not have as long a lifespan, but at least when it's with you, you know, your cat is actually happy. You know, that's okay. This is, it's all personal choice. It's, you know, cat individual, but that bet that's basically my take on it.
Kristiina (47:48)
Yeah, I agree. I think quality versus quantity is really important decision when you're talking about this stuff. And I think it also depends if you're talking about chronic illness versus kind of an illness that's going down, you know, like cancer, like we dealt with Steve where I pulled him off some of his medications that were just not helping him that may have extended his life, but we're just not making him feel good. So it was like, what are we doing? Like,
Gina Rendon (47:51)
Yeah.
Yeah. Yeah. Yeah. Yeah. Yeah. Right. Yeah. Yep. What are we doing? Why are we doing this? Yep. Yeah.
Kristiina (48:13)
What's the point of this? Yeah, like, let's just have him have more good days, even if it's less days in general.
Gina Rendon (48:18)
You know, the hard part is that you don't necessarily always know which way it's going to go. So not every cat reacts to every medication the same way. So it really has to be something that you experience on your own. And so sometimes there are medications that, you know, somebody else's cat may have found it very toxic, but your cat may tolerate well. To me, it's worth it to try to see how they are at taking medications and to see how they respond to it before.
Kristiina (48:23)
Right.
Mm -hmm.
Gina Rendon (48:46)
making a decision, but I wouldn't tell somebody to keep going if it made their cat miserable or if they were just, it ruined their relationship because they can't give it.
Kristiina (48:56)
I agree. And I often in my own practice, when I recommend medications that are again, these are behavioral medications and I can't dispense them. I'm not a vet. I have to work with a vet, right? Um, I just like to say that because I want everyone to know I am not a medical professional. I'm just a behaviorist. Um, but I really like to recommend that, especially when people are using these behavioral medications like floxatein, they do a transdermal ointment application, right? Um, because it makes it a lot less stressful for everybody. And I think especially with
Gina Rendon (49:05)
Mm -hmm. Mm -hmm. Yeah.
Really? Okay.
Okay.
Kristiina (49:26)
behavioral medications, if you're chasing a cat around to give them a pill or a liquid, you're just compounding the problem, right? Cause you have a stressed out cat that you're trying to make less stressed. And now you're chasing them around every night at the same time, probably to give them a pill. So now your cat is like waiting for this predictable, terrible behavior and getting more stressed and it just doesn't work. So I think medications that can be compounded in a way so that they're either more tasty or
Gina Rendon (49:31)
Mm -hmm. Mm -hmm. Right. Yeah, right.
Mm -hmm.
Right. Right.
Mm -hmm.
Kristiina (49:56)
on the ear or you know are just given in a way that may be a little more costly but are friendlier is great if that's possible if it's feasible I know you can't do that with all medications but I think a decent amount you can at least make taste less horrible
Gina Rendon (50:01)
a little friendlier. Uh huh.
Thank you.
Right, right.
Yeah, yeah. Or yes, yeah, exactly. If not, if it can't be given transdermally, you could get it into a flavored liquid or a flavored tab. They do the micro tabs. There's all kinds of ways to give medications these days,
Kristiina (50:22)
Right.
All right. Well, thank you so much, Gina, for appearing on this episode. It's always a pleasure to have you. I'm always so happy to talk to you. And I'm so grateful that you have been on this episode to educate all of us about FIP. And yeah, that's it. I don't know how to wrap this shit up. Wrap it up.
Gina Rendon (50:31)
It's always a pleasure.
I think that was perfect. That was