Friday, 8 May 2015

Pharoah tries stemcells for FIP and the cure for FIP is found!

With FIP there is no point being conservative except for the sake of the cat's comfort. So it was no surprise to hear that yet another innovative therapy is being tried - adipose stemcell therapy for dry FIP. The cat is called Pharoah and his vet is Ed Pattison of City Vets, Exeter UK

But how interesting is this - the vet who pioneered the use of adipose stemcells for arthritis in dogs in australia, Simon Craig, was the same chap who cured Dusty of wet FIP - see survivor's page

and how dull and unsexy is this - Hip arthritis in dogs by the way you can simply prevent with adequate vitamin C and a proper diet.
Dr Belfield has the word on vitamin c in animals and was kind enough to answer my emails when Mishka was diagnosed. he did try it for FIP of course and it was the one thing he had no success with after it was established :( That's what we are up against.
I have NO DOUBT this is the same with FIP - we can prevent it  simply - no rocket stemcell science required and finally someone in authority is brave enough to say it 
"The best treatment for FIP is not to get it in the first place: if you are going to buy a pedigree kitten, make sure your Vet sends a blood sample to the University of Glasgow Veterinary Diagnostic Services to get a certificate saying that the kitten tested negative for feline coronavirus (FCoV) antibodies: we need to put consumer pressure on bad breeders and reward good ones." Dr Dianne Addie rocks!
- see prevention page
  • stop inbreeding 
  • stop crowding 
  • stop malnourishment of starvation and stop feeding COOKED CRAP & KIBBLE to cats - they weren't designed to eat cereal; they are not birds.

Gus - pentoxifylline success part 1

Gus is the kitten of a pregnant shelter cat who was kept by hs mother's foster carer Nicole after she rehomed his mom and siblings. He was a more mature cat, and physically strong when he started getting sick. He never got very dehydrated or stopped eating so he stood a much better chance when Nicole went in to bat for him with Prednisone and Pentoxyfilline. These anti inflamatory drugs are easy to get and relatively cheap. pentoxifylline was an early choice for treating wet FIP that didn't pass trials - we still tried it, as have others on the facebook group.
Gus was a big cat- at 2 yrs old, he was 13 lbs! At one point, I sensed something wasn't right with him. He seemed lethargic (wouldn't interact with new kittens, in the past we had called him "Uncle Gus" because he always took the foster kittens under his wing, grooming and playing with them). He also felt bony along his spine- and his belly was bloated. I will admit, I wasn't too concerned at first. I thought worst case scenario, maybe he had gotten worms from one of the foster kittens he loved to groom. After a few weeks when he was still wasn't being his usual self, I took him to the vet.
October 26, 2103 The day my world crumbled.
I went in expecting a Dx of Giardia or a tapeworm... relatively easy fixes. Instead, I was told Gus had wet FIP. The vet actually withdrew fluid on the spot from his belly and showed it to me - thick, yellow, protein filled fluid. And he weighed 10.5 lbs. Still hate myself for not noticing the huge weight loss.All his lab values were abnormal , and he had a fever to boot. 
Initial lab work

I cried ( that is an understatement) in the exam room for about half an hour before i was gently escorted out.The only hope the dr. could offer me was palliative prednisone to improve appetite and the kind offer to come to my house to do the euthanasia when the time came.
I immediately started him on pred, and frantically searched for a second opinion/treatment options. A friend of mine worked for a local vet, and she told him my story. I reached out to him, and after a lengthy phone consultation he mentioned a drug called Pentoxifylene. He said it might help prolong his life. It's a drug normally prescribed for humans, for autoimmune disorders. A pharmacy in Arizona (Diamodback Drugs compounds it into animal dosages. I brought Gus to see him in the hopes that he would disagree with the original Dx. He broke my heart when he said all signs pointed to wet FIP and he couldn't go against my primary vet's Dx. BUT - he suggested the Pentoxifylene, saying it could potentially help prolong his life.

After 9 months on prednisone and pentoxifyllene Gus visited this vet again. His A/G ratio which had been very low, was back up and the other values that had been abnormal were all good.
New lab work
All lab values were normal, and the ultrasound showed NO fluid in his abdomen. His old chart had a WBC of 30,000 and very abnormal liver/kidney functions. And a fever. His WBC is now 9,000, within normal limits. He is also back to his playful mischievous self, a very happy cat. The difference between the two was amazing. The vet said if he did not know Gus's history he would say he was a perfectly healthy cat.
I am grateful for every day I have with him, and I don't mean to offer false hope. I know FIP is a terminal illness. All I know is that he is seemingly happy healthy and no longer shows any signs of the disease. Part of me hopes he was misdiagnosed, but another part of me hopes that maybe he did (does?) have this dreadful disease and there is in fact, hope. I am slowly weaning him off the meds while monitoring him constantly for any signs of a relapse. My heart goes out to everyone who is dealing or has dealt with this terrible disease. I'm fully aware Gus may be (probably is) living on borrowed time. I just feel like I need to share this in the hopes that it can help another.
 Gus part 2

Gus - Pentoxyfylline success part 2

Continued from part 1
Gus's foster carer Nicole kindly answered my questions in detail - texting on a phone! That's dedication for you.
Diet- no special diet. Gus always ate just Purina dry indoor formula. Once he got his Dx, he was spoiled rotten and I added canned friskies plus whatever protein I happened to be having for dinner- shrimp, ham, turkey, ect. Whatever he wanted. He was never put on an antibiotic that I can recall. When Dr. Ciance of Allenwood veterinarian hospital (in Allenwood NJ 732-528-7444) Dx'd  him she put him on 2 ml of pred a day to stimulate appetite and make him feel better. She also prescribed doxy ( doxycycline? a  broad spectrum antibiotic ) in pill form but I couldn't get him to take it, and her opinion was to not force it on him, let him enjoy his remaining time. We may have tried liquid, I can't recall. But he was never on antibiotics for an extended period of time.
Uncle Gus
Then I took him to Dr. Falk (Ocean County Veterinarian Hospital Lakewood NJ ). He was so kind and compassionate, even recommended a support group for me. He looked at the initial bloodwork and agreed that it looked like FIP. (see Gus's labs in previous post) He suggested adding pentox in addition to the pred. So, he was on 2ml of pred and 1 ml of pentox daily. This went on for about 5 months, the whole time Gus very slowly lost his belly bloat, gained muscle tone, and became more energetic. The two meds combined cost about $90/m from Diamondback, including shipping. (60 ml bottle of chicken flavored prednisolone and a 30 ml bottle of chicken flavored Pentoxifylene.) Always got the meds in about 3-4 days flat rate mail but I do believe they offer offer expedited shipping as well. They were great and very easy to deal with.
Gus tolerated the pred well, he did NOT tolerate the pentox. I would say on average he would vomit 7/10 times after I gave it to him. Broke my heart. I tried mixing 1ml of pred with 1/2 ml of pentox 2x daily, that was a little better but he would still throw it up occasionally. I played around with the timing and what seemed to work best was giving it to him about an hour after he ate. 
( Note: when we tried Mishka on pentox we follwed the advice to use a cream - she had no upset other than she didn't exactly like cream smeared on her ears ) Please note how careful they were about not taking Gus off any meds until he was definitely better on bloodwork and they wean slowly.
He isn't on any meds at all now, hasn't been since October 2014. When Dr Falk did new bloodwork and declared him either misdiagnosed or "cured", we decided to ween him off all meds. I stopped the pentox almost immediately since he hated it so much- did every other day for about a week and that was it. I went much slower with the pred, as u know u can't just stop it cold turkey. I slowly decreased his dose over a month, down to 1ml, then did 1ml every other day for about 2 weeks, then 1/2 ml every other day for about a week, and that was it.

the Fab4 including Gus
I Have fostered about 75-100 kittens over close to 3 years... as far as I know none of them have ever been Dx'd with either form of FIP. I did have 2 pass away from dehydration and Giardia (they passed away 2 days after I had them, they were in very bad shape when I took them in). Every other cat/kitten has been a success story as far as I know. I have 3 other cats and none of them have ever had any major ailments -unless u count my 12 yr old Oscar just having 5 teeth pulled Poor guy.
Yes, I stopped fostering. I actually had 12 wk old brother and sister kittens in my house when Gus was diagnosed, I immediately had the rescue take them back (a friend's mother has since adopted them both)!
Gus is strictly and indoor cat. I live on a busy street. I fostered his pregnant mother and he has been with me every day since birth. My mother kept his mother and his sister, and I keep in touch with the woman who adopted his brother and other sister. As far as I know none of them have had any major health issues to date.

Thursday, 29 January 2015

John Robie - farewell to a FIP fighter Aug 10 2014

Here is the maverick John Robbie who stole Lisa Cone's heart. Cat owners will appreciate how much he meant to her. He was unique in every way. His unconventional FIP story gave us all hope but he has finally run out of lives and has gone into the next world now. I tip my hat to Lisa who did the very best for her cat. John Robbie's chronicle is sprinkled around this blog - just use the tag cloud to look him up.
(On a therapy note I still don't really understand why Dr Addie is so adamant about promoting arginine and stopping JR's lysine which he had been taking since birth to treat another virus that damages nerves (lysine blocks arginine uptake which herpes needs to replicate - it keeps the lid on herpes in humans as well. ) It's a food, a simple protein that is more easily damaged by cooking than arginine with which it shares a balance that on a natural raw cat diet would not be upset in favour of arginine.)
from FIP fighters facebook posts:
(4/7/14)He is still holding his own. He is on MASSIVE amounts of drugs including full dosage of Pred and 6ml of PI daily. But he seems (knock on wood) to be stabilizing again. I won't feel good about it until I have a good 6 weeks of stable. Then maybe we will talk about decreasing meds. He is one expensive little cat at the moment. (And he looks quite pudgy in this picture when he is usually so pointy!) We are nearing 2 years 
(Aug 10 2014 )We are saying goodbye to John Robie in about 1/2 hour. He has been an amazing fighter for almost 2 1/2 years. His FIP has moved into his spine and back legs. He is peeing on himself and can't really walk. I don't want to see him get any worse. Good bye my love. You are the best cat ever. 

Tomten - Where do you go when your cat has stumped all the vets?

A: a cat specialist - case solved by Dr Plotnick!
The first blog post on I wrote on his case was the Winter Tomten "Yuletide " the midpoint of winter - the cosmic balance between life and death". I feel like we are poised on such a tipping point - and i cant help thinking being in the southern hemisphere the december solstice signals the descent." If you want to follow his story in graphic detail use the labels to find the other posts but now for the news i should have updated months ago! Tomten was originally thought to have FIP around the same time as Mishka. He had already started feline interferon so I drew a lot of strength from the kindness of Cassie answering my emails 2 years ago. For Cassie the drug was a really really big ask as it is hard to import to the USA as well as super expensive. 

"He who asks a question is a fool for five minutes; he who does not ask a question remains a fool forever." - Chinese proverb

 So glad her persitence paid off: June 2014 Cassie posted -
Finally a possible explanation for Tomten's illness. Ok I have truly crossed over to crazy cat lady. While making Tomten's next appointment for his Cardio check up I began feeling frustrated that he still has no diagnosis. So I broke down and submitted an e-mail to Cat Fancy magazine's ask the doctor. I felt a bit silly but figured what could it hurt? 
My 7 year old Devon Rex has stumped all the vets he has seen. 2 years ago he stopped eating, started throwing up and was hiding. An emergency trip to the local ER showed that he hadgranulomatous tumor in his intestines. An aspiration of the tumor ruled out lymphoma and based on his blood work he was diagnosed with dry FIP. He was put on feline interferon and methyl prednisone and sent home to die. Only a “miracle” happened and he appeared to get better over the course of two months. Three months after diagnoses scans showed that his tumors had disappeared through his lymph nodes remained swollen and abnormal. 12 months after the first tumor appeared he stopped eating again. Scans showed 3 new granulomatous tumors one of which was in danger of perforating his bowel. At this point his vet moved him to an excellent large regional vet hospital. They consensus was that he didn’t have FIP (based on his longevity). Since he was no longer responding to the feline interferon the thought was to do surgery to remove the tumors. All 3 tumors where removed in a double bowel resection and subsequent gram staining of the tissue was negative for FIP. He appeared to recover for a bit and then went into a tail spin hiding and not eating. He was placed back on the methyl prednisone and within a week was recovering once again. 3 months later he developed an ear polyp and infection and lost his balance. A month of antibiotics and dedicated ear cleaning and he recovered much of his balance but his counter surfing days where behind him. When he was being evaluated to remove the ear polyps it was discovered that his heart had become greatly enlarged and he was in heart failure. We made the decision to leave the ear polyps and focus on managing his failing heart.
Tomten has been lucky to have better care than many human beings and we are very grateful to his vet teams, who have given him an additional two years of life. The vets have all been unanimous that what ever is causing his health problems is an unknown and perhaps is some sort of an autoimmune disease? While we have tried to make peace with the fact that we will probably never know what is wrong with him its hard not to wonder if we took him somewhere else would someone know what is causing his condition? And could we do anything to stop it other than to treat each symptom as it comes up.
Dr Plotnick's Reply:
I think the ear polyps and the heart disease are separate issues. Devon Rexes are at increased risk of developing hypertrophic cardiomyopathy, which is the heart disease I suspect he has. As for the intestinal disorder, it sounds like your cat has granulomatous enteritis. This is a mysterious illness. Inflammatory bowel disease is a common disorder in cats. With IBD, most cases are due to infiltration of the intestines with either lymphocytes and plasma cells, or with eosinophils. These are types of inflammatory cells. Every now and then, we see a case that doesn’t fit into this pattern. We see what they call granulomatous inflammation. In these cases, the intestines are infiltrated with lymphocytes, plasma cells, macrophages, neutrophils..a whole mishmash of inflammatory cells. It often affects a discrete region of the intestine, rather than diffusely infiltrating the intestines. (Diffuse infiltration is the more common scenario.) (The disease has sometimes been called “regional enteritis” because it affects a discrete region of the intestine). FIP likes to cause granulomatous inflammation, but not all cases of granulomatous inflammation are due to FIP. When granulomatous inflammation is seen on an intestinal biopsy, the specimen should be stained with a special stain that detects coronavirus in the tissue. If the stain comes back positive, the cat has FIP, and the prognosis is terrible. If the stain comes back negative, it rules out FIP. However, the prognosis for granulomatous inflammation in the intestine is unknown. It’s a mysterious disease that no one has really figured out. Some people try steroids, and they work for some cats, in some cases. Other people suggest surgically removing the affected area. There are no big case studies of cats with this type of enteritis, so we don’t really know what the best treatment is. Unfortunately, I think the best approach is the one you’ve been doing, i.e. treat the symptoms as they come up. With him having heart disease, steroids are not recommended because steroids expand your cat’s blood volume, which can put a strain on the heart. I’m not sure how you would treat another bout of granulomatous enteritis if it were to develop again. Good luck with him. I hope he does well.
Dr. Arnold Plotnick
I've asked Cassie for an update - i know some on the facebook group had reccomended the raw diet as she was investigating IBD - Irritable Bowel Disease.  

PS. I love Dr Plotnick's idea of a cat only vet - cats hate the fuss and stress of a regular clinic full of dogs. Poor Mishka's worst moments were not from FIP so much as the 'system' - I won't spoil this feelgood post with the details of that - contact Dr Plotnick

Tuesday, 27 January 2015

Tomten - PCR negative for FIP

oh dear dredged out of my drafts so it's older than this by months but rest easy Tomten seems to still be fine as far as I know. This was written before Dr. Plotnick gave Cassie his helpful email in .
"The News I have been hoping for is finally here..... Dr. Ratti just called me a few minutes ago. UC Davis Vet Hospital just called her. Acting on Dr. Addie's advice she has sent a PCR of his effected tissue to a researcher there. The verdict is this is not FIP!!!!!! (second time in his six years I have heard that and its just as sweet the second time around. First time it was herpes when he was a kitten).

Since we had tested him last year when he first got sick for Lymphoma they have ruled that out. The current hypothesis is he has some foreign bodies embedded in the intestine that has caused the granulomas and with surgery maybe there is still a chance. Because it will be a complicated surgery (two granulomas) and he is weak she wants him at a full service surgery center with access to ultrasound equipment at the operating table and the 24 hour critical care. She will be researching Redbank and Garden State Hospital. Because Tomten is somewhat stable, not getting worse but not getting better she wants us to wait until after the Holiday week so where ever he goes they will have a full staff.

I am elated by the news but terrified for him. He will die without the surgery and with it at least I know he has a chance. He is truly a fighter. In his six years I have been told he is dying 4 to 5 times and he battles back. I hope he has it in him one more time.

The foreign body theory makes some sense to me as he has a bad habit of eating wrapping paper ribbon, rubber kids toys, and straw etc. As much as we try and keep these out of the house they sometimes slip in unnoticed. 3 months ago my son brought home a party favor bag and we didn't realize it was tied with wrapping paper ribbon. He got it ate , got sick and passed it... but I can't help but wonder if he didn't pass all of it. Ditto there have been numerous other incidents over the years so its possible.

Sorry I am rambling on today... A lot of emotion. We have been in Limbo with FIP for so very long." ~ Cassie
I don't know what to say other than Tomten is one sick cat. His fur has not been so shiny and nice apparently for the past month. One has to wonder if the interferon is contributing significantly by holding the herpes at bay or in some other way. I don't suppose you should just withdraw it after all this time - but the latest news on Tomten was he pulled through again and in  Cassie finally got some diagnostic insights and peace of mind from a very  unexpected source read on - where-do-you-go-when-your-cat has stumped all the vets?