Merck Manual

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Drugs That Have Been Suggested for Use in Feline Infectious Peritonitis Cases

Drugs That Have Been Suggested for Use in Feline Infectious Peritonitis Cases

Druga

Comment

ABCD Recommendation (EBM Levelb)

Antivirals

Ribavirin

Active in vitro but toxic in cats

Not recommended (2)

Vidarabin

Active in vitro but toxic in cats

Likely ineffective (4)

Human interferon-α, SC, high dose

Although effective in vitro against FCoV, SC treatment did not work in an experimental trial

Ineffective (2)

Human interferon-α, PO, low dose

No trials. Only acts as immunostimulant if given orally; immune stimulation should be avoided in cats with FIP

Contraindicated (4)

Feline interferon-ω

Single placebo-controlled study of naturally occurring cases and one uncontrolled study

No benefit was observed (level 1 study); may require further studies in view of anecdotal clinical evidence (4)

Polyprenyl immunostimulant (investigational drug)

Upregulation biosynthesis of mRNA of TH1 cytokines, uncontrolled study treating three noneffusive cases, long survival

May have some beneficial effect in noneffusive FIP (3); controlled studies required

Immunosuppressants

Prednisolone/dexamethasone (immunosuppressive doses)

No controlled studies; some cats improved during treatment and survived for several months; does not cure FIP

Currently supportive treatment of choice (3); if effusion is present, dexamethasone intrathoracic or intraperitoneal may be helpful

Pentoxyfylline

Aimed at treating vasculitis

Ineffective in one case study (4)

Ozagrel hydrochloride

Thromboxane synthesis inhibitor aimed at treating inflammatory response; only used in two cases with beneficial effect

Controlled studies needed (3)

Cyclosporin A

Immunosuppressive; no published studies

Not recommended; more directed against cellular immunity than humoral (lack of data) (4)

Cyclophosphamide

Immunosuppressive; no published studies

Might be considered in combination with glucocorticoids (4)

Chlorambucil

Immunosuppressive; no published studies

Might be considered in combination with glucocorticoids (4)

Azathioprine

Toxic in cats; immunosuppressive; no published studies

Not recommended (4)

Acetylsalicylic acid (aspirin), platelet inhibitory dosage

To treat inflammatory response as well as vasculitis; no published studies

May have some beneficial effect, but adverse effects possible if used in combination with high-dose glucocorticoids

a Many of the treatments listed represent extra-label use for treatment of FIP.

b Evidence-based medicine (EBM) level 1 = confirmed by randomized controlled clinical trials in target species; EBM level 2 = confirmed by randomized controlled experimental studies in target species; EBM level 3 = supported by case series, other experimental studies, nonrandomized clinical trials; EBM level 4 = based on expert opinion, case reports, studies in other species. Modified, with permission, from Feline infectious peritonitis. Guidelines of The European Advisory Board on Cat Diseases (ABCD), © 2012 Advisory Board on Cat Diseases.