Treatment with Remdesivir for FIP in Cats

Updated April 27, 2023

Important Note to Cat Owners: This page was written early in the treatment of FIP, when knowledge and access to drugs was scarce. Today, your own vet is fully capable of administering the treatment and saving your cat. For the best up to date information on treatment protocols and drug availability in Australia, please visit the page of Turramurra Veterinary Hospital.

I’m sorry that I do not have local information for cat owners outside of Australia.

Now read on!

The nightmare is almost over. Until very recently, a diagnosis of Feline Infectious Peritonitis was a death sentence. Either a slow, lingering decline or a decision to euthanase and spare the suffering. This happened to around 1% of cats, most of them kittens.

Then it was discovered that certain antiviral drugs could not only improve the symptoms, they could actually bring about a cure. But there was still a hitch.

These antivirals weren’t licensed in Australia, and therefore illegal to import and use. So the only cats who survived were those whose owners and vets were prepared to take the risk. My own veterinary association shamefully advised against their use, despite the evidence.

All that has ended for Australian cats.

We apologise that for legal reasons we are unable to assist outside of Australia.

Remdesivir: A New Hope For FIP

You’ve heard of remdesivir. It was rushed through TGA and FDA approval due to promising results in the treatment of COVID-19. What’s important about remdesivir is that it’s almost identical to those black market drugs like GS- 441524.

Except this time it’s freely available with a valid prescription, and has all the quality controls we expect from licensed drugs. Vets still need to warn you about ‘off-label’ use, but this is the same discussion we have whenever we pick up a human drug (which is often!)

Preliminary trial work in Sydney has produced excellent results. So now we have a drug for all. I estimate that less than 5% of cats with FIP a were previously being saved using GS. We should now see all owners getting offered the chance, and most taking it up, though cost issues still exist.

Costs Of Remdesivir Use In Cats

As you can imagine, it’s an expensive drug. A rough estimate is that a course of 80 days’ treatment costs around $8000 to $10000

However, dose for dose, this is very similar to the prices people were paying for black market GS- 441524 of unproven purity or efficacy. This time, if a cat is insured, the insurance company is likely to pay for it as well. Read a longer comparison of GS and remdesivir here.

Based on our experience, 84 days of treatment should bring about a cure in the large majority of affected cats. It’s administered as once-daily subcutaneous injections, but don’t be put off. Everyone can do it, and we are happy to show you how.

UPDATE: By late 2021, we had successfully treated around 30 cats, with only a single failure in a neurological case. Doses of remdesivir are now higher than initially recommended. We now also have access to pharmaceutical-grade GS- 441524 in tablet form, which is both a little cheaper and easier to use for some owners.

Protocols remain at 84 days. Those going onto tablets are recommended to start with injections for the first 4 weeks.

We are all thoroughly indebted to the work of Dr Richard Malik DVSc PhD FACVSc FASM and the feline research team at my alma mater The University Of Sydney.

We are also indebted to the volunteer groups who, by taking on the risk, have helped many cats back to health. Their job is done, and we’re grateful.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

76 Replies to “Treatment with Remdesivir for FIP in Cats”

  1. My 9 year old cat became ill and after blood work was done it was determined that she probably has FIP. Her globulin levels were high. She was anemic and had a fever. She had normal levels of everything else. I did the 84 day treatment of Aino(alleged gs-441524) via black market. 29 vials. Almost immediately she started getting better and gaining weight. She is one week into her 84 day observation. And still doing very well. It’s sad to watch your animal get sick. I was fortunate to find the Facebook group that helped me all along the way. I don’t know what was in those vials, all I know is, it works.

    1. Hi Andrew please reply this is urgent –

      My kitten currently has a fist size mass in his abdomen, jaundice, and was breathing through his mouth. 150 mL of yellow fluid was extracted from his chest. His belly also distended a bit. I was told that he has both wet and dry FIP, I know you mentioned that this is not uncommon but would the dosage for Remdesivir be according to the wet or dry FIP? He was doing okay the past couple of days – he eats a bit, seems happy but after his third injection he seemed really tired and can barely open his eyes. His third eye is visible and its a translucent yellow colour. Is it normal to have ‘bad days’ sometimes? His urine is also very bright yellow. He is currently prescribed 10mg/kg. He is breathing ok now after extracted fluid.

      1. Hi Cat. For legal reasons I can’t give individual doses without inspecting an animal. I’m really sorry. It sounds like the care you’re getting is quite standard though.

  2. Recently, I’m having a surge of FIP in my feline patients and consistently falling to help them. At my place, initially it starts with mild constipation and affected cats goes off the feed. I try with all kinds of both short and long acting antibiotics and DNS. Unfortunately, they die. On postmortem examination the peritoneal cavity accumulates yellow fluid. It takes 5-10 days to die once the disease starts. My observation is: in Dhaka, Bangladesh FIP mortality is 100%. Some times it confuses me with those of FPL. I’m not certain if it is communicable to the humans and has had any zoonotic importance. Thus, looking forward to work with other laboratories to diagnose this disease before it goes out of control. Regards.

    Professor of Pathology and Owner/Practitioner,
    Blue Crescent Veterinary Hospital
    +88 01711 430 531 (cell)

    1. Hi Mohammed. Being reasonably familiar with the scientific literature, I am unaware of any human health implications. Testing has also been extensively researched but it remains a great problem to diagnose the disease antemortem in most cats. Speaking as vets who are unlucky enough to see this disease regularly, in the majority that we see, we make the diagnosis using our experience as much as laboratory testing. Treatment as outlined in this and the linked articles is very successful, but quite expensive. Good luck and feel free to get in touch to share notes.

    1. Hi Angel. I’m not sure what other vets think, but my opinion is that there is no ethical problem with breeding a cat who has recovered from FIP, as the condition is not genetic.

  3. hi i have two spyhnx one in observation and one in treatment once both cured will they be able to breed or will there offspring now get it? there catteries they come from never had issues with fip before? they come from 2 different catteries.

  4. Hi Andrew my cat has feline aids,sadly he has been treated by vet for for on going cat flu, last night,i have notice his belly is getting larger like FIP had you had a cat do this course with F Aids and recover,or is this just a too bigger dream thanking you for caring for so many cats now can be saved Janet

    1. Hi Janet. We have successfully treated one cat with combined FIV and FIP. However, in your case you need to get an accurate diagnosis first, as there are probably other more likely explanations for the enlarged abdomen. Good luck.

      1. What dosage would you recommend for a 4.5 lb kitty with the neurological form of FIP? Thank you

      2. Hi Kelly. There is no consensus on these most difficult of cases, and some vets are using very high doses. Each is assessed individually I’m afraid.

  5. Hi Andrew,
    Could you tell me please, what prognosis would be with Remdesivir for 6 months kitten with dry FIP with neurological signs?..

    Thank you

    1. Hi Jolanta. The prognosis is not as favourable but we have had good responses with a few we have treated. They need much higher doses of course.

    1. Hi Rohan. The prognosis for the wet form appears excellent – in our clinic we have had 100% survival so far based on around 10 cats. For the dry form it still seems pretty good but we have lost one kitten out of four or five treated.

  6. Hi, Andrew. Can you provide me the costing per vial? And where i can source myself? Not sure if my vet is overcharging me or not as my kitten has just been diagnosed with wet fip. Thanks

    1. Hi Kyu. If you live in South Australia will be only too happy to provide pricing if you contact the clinic directly. Otherwise, check the other vets in your local area as pricing is very much an individual decision and likely to vary.

  7. Hi, could you please share the remdesivir dosing for a wet fip ? My 5 month old kittne may have the condition and we’re trying to source the vials. thank you in advance

    1. Hi Jae. We are very happy to share the protocol with your vets – just get them to contact us on the clinic email and we will send it across to them. However, you may have trouble accessing remdesivir outside of Australia depending on local supply. Therefore, also look at what I have written about GS – 441.

  8. Hi Andrew,

    i’m from Canada and our cat was diagnosed with FIP. We are fetching a second advice from another vet here in Montreal. Are there any options to have your team work with our Vet here in Canada and help accompany the treatment?

    1. Hi Sébastien. You should find that your vets have all the information they need, but if not, feel free to get them to contact me and I will send information across. However, availability of certain drugs will depend on where you live in the world.

  9. Hello Andrew, my name is David. Our 18mth old Scottish Shorthair was diagnosed with FIP and our local vet has emailed you this afternoon for guidance as to how to source Remdesivir, as we are struggling to find them locally. Can you please let us know when and if you see this message

    1. Hi David. I contacted the vet yesterday when I returned to work. There really should be no problem in Australia.

  10. I purchased an oriental kitten from a breeder in Sydney, when he developed FIP at 7/12 old I contacted her and she showed no interest except to assure me it was now curable. Should I have expected more?

    1. Hi Linda. It’s hard to pin the blame on the breeders as there doesn’t seem to be much they can do to control the incidence. It’s just a shame they didn’t show a little more sympathy.

  11. Hello My son is pet parent to two kittens now about 7months. He adopted them both at 2months. One is a Bombay her name is Bambina she was just diagnosed yesterday with FIP. He has joined a FB group & was encouraged to buy the oral tablet Mutian. Is this the same as the shot of GS 441 ? Also have you had success with it if you’ve used it?

    1. Hi Nadia. I have personally known owners who have chosen to use Mutian and it has worked well. However, I still preferred GS – 441 if the owner was capable of giving injections. Nowadays of course we use remdesivir here.

  12. I run a small rescue and have had 3 x4 month old kittens pass away in the last week, the vet hospital said it was wet strain FIP, fast and horrible deaths. I have 7 more kittens/cats in the house. I am trying to find foster carers to reduce number. Some are sneezing and have slightly swollen eyes, I think we are going to be hit again and I desperately want to save them but 10k is just not viable, is there cheaper treatment out there in Melbourne.

    1. Hi Acica. The only other option you have is to talk to your vet and FIP warriors about the black market drugs that preceded remdesivir. We no longer advise them, but if it’s a matter of life and death you may have a different opinion. Costs will be lower for you regardless due to lower body weights and hence doses. Also, it’s very unlikely that upper respiratory signs are associated with FIP – this should be a separate infectious disease.

  13. Can you recommend an Australian pet health insurer that will cover this type of treatment?

    My 14 y/o Burmese Mandalay suffered extended belly for a number of years, we thought she was getting fat but in the last year she was getting bigger. Three weeks ago she got very bloated and a local Adelaide vet drained the abdominal fluid (1l) and offered cancer or heart failure as a possible reason.

    However after reading this site the disease progression matched exactly for FIP: long term ‘barrel’ like stomach then sudden severe bloat, lethargy, appetite loss, ataxia, fever, collapse and death. So my lovely companion is sadly gone and I’m heartbroken at our loss but realise now that without the correct diagnosis there was sadly nothing we could have done to stop it.

    So we will get another now very expensive Mandalay kitten but this time with pet insurance. Can you recommend a cover that will cover this type of FIP treatment in Adelaide SA?

    1. Hi Robert. I actually think that FIP is an unlikely diagnosis in a 14-year-old (or even 12 year old) cat. I feel that at least statistically the diagnoses you mention are more likely. Regarding your insurance question, we have been disappointed to find that the insurance companies have rejected treatment with Remdesivir and we are still fighting to get it recognised. Therefore, at the moment I can’t make any suggestions.

  14. I live in New York City (US) and I have been rescuing cats and kittens from the street. Recently one of my rescues was diagnosed with FIP and the adopter, who has had her for several months is willing to pay what is needed to keep his beloved kitten alive. She is about 8 months old. Is is possible to obtain the medication here in the US from Australia without having to go through the “black market?” Is it possible now that you are treating for FIP that other Veterinarians in the US will do the same. So hopeful for this information. FIP has been a death sentence for so many rescues.

    1. Hi Wendy. It’s likely that your vets are already aware of the treatment, and that compounded remdesivir can also be obtained legally inside the US. We certainly cannot ship it for you I’m sorry.

      1. Thank you for your response. I have approached several Veterinarian’s here in NYC and none are acknowledging that this medication is available. The adopter of the kitten did purchase through the BM despite the Vet recommending euthanizing, and the adopter has said that it is a miracle that after 3 days of treatment, they are seeing positive results. I too am shocked. If my Veterinarian is willing to reach out to you to discuss, would you be willing to communicate with her?

      2. Hi Wendy. If you may have no alternative, the existing treatment using GS441 has been working well for most kittens – look for a Facebook group called FIP warriors.

      3. Hello Andrew,
        I reached out to the only distributor of Remdesivir here in the US, Amerisource. The product is owned and controlled by Giliad, and just FDA approved. Remdesivir is called Veklury. Amerisource is currently only allowed to distribute to hospitals for human/medical use. Veterinarians cannot obtain this medication. So we are now back to BM access. Yes, I am familiar with FIP Warriors. Your information has been very helpful and it gives hope to the cat owners in the US.

  15. Just remember the dosage rate is all depending on the cats weight as it get healthier and heavier weather it’s wet or dry FIP it will need more from what I’ve read online ????
    And since it will be legal and not black market product it may be covered under a vets treatment with pet insurance Bonus.
    Personally if it’s not covered by pet insurance we would still have the treatment done we would find the money.

    1. Hi Fabiano – yes, we always have to factor in the increasing weight as the cats respond to treatment. The protocols have different dose rates mentioned further on in the comments.

  16. My cat has just been diagnosed with FIP, and I live in Adelaide, Australia. We’ve considered getting black market treatment but now we’re hearing this, we wonder if there’s anywhere in Adelaide that would be able to perform this treatment….

    1. Hi Mia. You may not be aware that our clinic is actually in Adelaide so you can contact us once we reopen on Tuesday.

      1. Hi Andrew my cat has been diagnosed with FIP us there a vet in Melbourne that give help my furbabie?

      2. Hi Sandra. You are sure to find a vet – I would choose a multi vet practice to improve the chance that someone has heard of this treatment, and feel free to get them to contact me for the protocol if they don’t already have it.

  17. I am so happy yet crying at this news. We adopted a beautiful little shelter kitten at the start of October and she was dead 11 days later, aged just 12 weeks, from wet FIP. Her death came after losing one of our dogs and the two deaths were three weeks apart. I totally fell apart and when I approached Cats Protection about getting another kitten I was informed I had to quarantine for seven weeks due to the FIP. I was mentally not doing well at all and have still not yet got back to things like my old exercise routine, but I have been able to adopt a stunning young 13 month-old white cat with amputated pinnae (dodgy lesions) and an enucleated eye (feline herpes). We are delighted with her but I still wish our precious kitten could have lived.
    Shelters must be rife with FIP-inducing conditions, we need far more awareness of FIP and quarantine after death – the shelter I got the FIP kitten from offered me another immediately and what if that had fallen ill too?!
    Our kitten had been seen by a vet who diagnosed simple cat flu, but sadly the cat was so much sicker than anyone could have known. She went to bed ok and by breakfast time she was barely able to move, gasping for breath, and almost collapsing. It was deeply distressing and I wish we could have accessed a drug to save her, as she was insured at the time. FIP has taken too many cats far too soon, leaving broken-hearted families who may be totally discouraged from owning a cat ever again. We MUST do whatever we can to raise awareness and fight this monster, it has fed on enough lives. No more. THANK YOU ❤️❤️

  18. Dear Andrew, this is amazing news! Thank you for sharing! I was talking about this with my vet (here in Amsterdam, in The Netherlands) just a few days ago; that she would use Remdesivir in her clinic as legal alternative for GS144 when it would be available and now it is! Costs will still be an issue for many cat owners, I fear, but at least vets can now offer a treatment without risking their license. I will send her the link to your article. I was one of the (many) people that took that leap of faith; I treated my cat with the ‘black market drug’ GS144 after she was diagnosed with dry neuro FIP in February this year. She’s cured now! 🙂

  19. Please don’t forget to credit Dr. Niels Pedersen and the research that he and his team have produced at UC Davis.

  20. Once a cat has FIP and is healthy again. Is it allowed to breed with him??
    We used this medicine and our cat is cured.
    This question nobody can give an anwer on this.

    1. Hi Martin

      Yes, nobody knows the answer to this question. My view is that the virus will have been completely eliminated in cured cats and they can be safely bred, but I cannot guarantee this is accurate.

      1. A cat that has had FIP should absolutely never be used for breeding! There’s a strong genetic factor involved in the development of FIP. This has been shown in several scientific studies.

      2. Hi Anna–Lena. I am unaware of the studies and would be very grateful if you could reply with their references.

  21. Super good News!! We run a vet clinic in Berlin, Germany and would really apprechiate if you could send the documents about dose rates to us. Thanks so much in advance!

    1. Yes, will do. To other vets, please continue to send requests like this and I will forward the document without posting your comment.

  22. My 4 month old Maine Coon was stricken with FIP shortly after neuter surgery. GS144 saved his life – dry neuro. We are now nearing 60 days on observation with perfect bloodwork. I am so pleased to hear that remdesivir will soon be able to save more cats legally, and while it is expensive, I have no doubt it will be a welcomed alternative to certain death. Looking forward to hearing it is available in the US!

    1. Hi Kathryn. I’m sure it will be soon. Thanks for highlighting that it’s not about criticising what was done before, it’s about broadening the treatment so that it’s available to all cats.

  23. I’ve successfully treated our cat using GS 44 that same lab in. China also manufactures Remdisiver fir humans so in actual fact I take exception to your implication that GS quality is questionable. Based on my experience.

    1. Hi Ann. We too have assisted many cat owners who chose to treat their cats with GS – 441 and they mostly had good results. The problem is that the drug is unregulated and its use is entirely reliant on trust. It not only poses a legal threat to those that use it, but lacks all the normal safeguards of approved medications.

      1. Off-label use of remdesivir would achieve the same exact problems in my view. 🙁
        Where can we vets find the protocol or background studies?

      2. Hi Alex. It’s possible that your country has less legal issues with the older approach, but for us remdesivir is certainly much easier. To look up background studies, search for anything involving Neils Pedersen and FIP – most are open access. As for the remdesivir protocol, request it from a vet email address and I’ll send it straight over.

  24. My kitten got the virus and he was treated with the Gmeds. He seems to be doing well. One month for blood work to see if we killed the virus.

  25. I own a veterinary clinic in Athens, Greece and I am very interested in protocols and doses for the treatment of fip. I would appreciate it if you sent me information. Thank you in advance

      1. I am a feline veterinarian in California, United States. Would you also share the treatment protocol and dosing information with me?

    1. Hi Sam. It’s likely that wherever you live in the world, local vets will have access to dose rates.

  26. Dear Dr Andrew

    I co-founded FIP Advisory and Care Group. Our group has been opposed to the black market use of GS441524 since it has been made available, pushing for alternative legal and approved treatments. Till now we have suggested RetroMad-1, Polyprenyl Immunostimulant and such, however, we have been keeping an on Remdesivir as it is the pro drug of GS441524.

    You mention in your article a protocol for treatment using Remdesivir. This I would imagine extends to the generics such as Bemdesivir too? Would you be willing to share this protocol with us so that we may suggest it to vets and cat owners?

    Our one co-founder has a long term survivor of dry FIP on Polyprenyl Immunostimulant. Her cat has now celebrated 7 years post diagnosis. Although Polyprenyl Immunostimulant is not as effective, and seems to only work in some cats, we have suggested it be used in combination with treatments such as RetroMad-1 and Feline Omega Interferon, in the absence of other treatment options. This is based on the philosophy of Dr Gary Whittaker of Cornell University, and Dr Leslie Lyons, who suggest that treatment of FIP requires both an antiviral and immune support.

    I would really like to hear back from you.

    1. Hi Aurora. It’s great to talk about such an interesting and important topic. I’m sorry that I don’t feel able to share the dosing information as I am not the author, but the researcher mentioned in the article is easy to find online and I would suggest contacting him directly. I suspect he will be quite happy to provide a document. As for the generics, I’m quite in the dark I’m afraid.

      1. Yes indeed, Dr Pedersen is such a nice person, he has helped me a few more owners, and he has always shared his protocols with us via email. And Andrew is quite correct, if you do a search on Dr Pedersen published articles, you will see the dose protocols are all in there. And he’s email is also in the heading of his articles. I hope this helps you. Regards

      2. It’s worth noting that Dr Pedersen uses a dose of 4 mg per kilogram in his main article on GS441, and our document has higher doses for remdesivir of 5 in uncomplicated cases, 8 with ocular involvement, and 10 with neurological signs. Of course, these have only been worked out empirically and must be treated with caution.

    2. Meanwhile, thank goodness people who did not want to wait for alternatives while watching their cat die a slow painful death have been able to obtain blackmarket GS 441524. [edited by AS to remove some harsh language]

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