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

ABSTRACT 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.