| dc.description.abstract | Objectives: The aim of this study was to identify potential predictors of outcome of treatment with RDV and GS-441524 in cats with Feline Infectious Peritonitis (FIP) on admission to an intensive care setting.
Study design: A retrospective case series type study was performed.
Methods: Cats diagnosed with FIP at two different hospitals between June 2023 and April 2024, that were included in a larger scale FIP-treatment trial conducted at the Faculty of Veterinary Medicine at Utrecht University, and were admitted to an intensive care setting, were included. Medical records of these cats were reviewed (IDEXX Animana or Provet Cloud) to collect data, including medical history, signalment, physical examination findings and findings from additional diagnostics such as laboratory parameters and diagnostic imaging. Testing for association of variables and outcome was done in two stages. First, univariable logistic regression was used to identify potential prognostic predictors and variables that were considered significant were offered for multivariable logistic regression.
Results: a total of 37 cats were selected for this study. Cats that showed positive clinical response to treatment and made it past the 28-day period were marked as “survivor” (S). Cats that did not make it past the 28-day period were marked as non-survivor (NS). About 70.3% (26/37) of cats survived at least the first 28 days of treatment. Out of the eleven cats that did not survive, six died within the first 72 hours of treatment (54.5%). Cats with signs of neurological involvement at any point – although not statistically significant – seemed to more frequently not survive the 28-day period. Significant association was found between outcome and two categories within the evaluated variables on admission, namely measured plasma bilirubin levels exceeding 60 μmol /L (OR = 24.28, 95% CI = 1.83 - 1008.54) and a rectally measured body temperature below 38.0 degrees Celsius (OR = 57.83, 95% CI = 2.75 - 4337.56). Cats within either one of these categories of variables had significantly higher odds for poor outcome (NS) compared to their reference groups (total bilirubin ≤ 30 μmol /L and body temperature between 38.0 and 39.0 degrees Celsius, respectively).
Conclusion: This study found possible association between survival at 28 days and extent of hyperbilirubinemia and hypothermia. Additionally, signs of possible neurological involvement seemed to be more frequent in cats with poor outcome. Response in the first few days of treatment seems to be of importance, since more than half of cats that succumbed to disease did so within the first three days of treatment. These findings emphasize the usefulness and possible prognostic values of plasma bilirubin and body temperature measurements before treatment with nucleoside analogs is initiated. Along with these, the presence of neurological involvement and the response to treatment within the first few days can possibly be of aid in roughly estimating a prognosis. More research with focus on critical care cases within this topic and with larger sample sizes needs to be conducted to support these findings. | |
