Breaking FIP Mews! Now your Vet Can Help!
We had the pleasure of chatting with Steve Dale about the brand-new advances in the treatment of FIP (feline infectious peritonitis) which has always been considered 100% fatal. Find out what has changed since our last episode discussing it. Could your cat be at risk? Make sure you know the latest info and be sure your vet does too!
Listen to Episode #128 Now:
BIO:
Steve Dale, certified animal behavior consultant (CABC), has reached more pet owners over the past few decades than any other pet journalist in America.
He is the host of two nationally syndicated radio shows, Steve Dale’s Pet World and The Pet Minute (together heard on more than 100 radio stations, syndicated Black Dog Radio Productions, since 2005). He’s also a special contributor at WGN Radio, Chicago, and program host of Steve Dale’s Pet World(since 1997). He formerly hosted the nationally broadcastAnimal Planet Radio.
For 21 years, his twice weekly newspaper column was syndicated by the Chicago Tribune. Steve was a contributing editor for USA Weekend (2002 to 2014), and regular columnist at Cat Fancy magazine (2006 to 2014). He has written for a long list of magazines, from People to Dog World (where he was a columnist).
He’s currently a columnist and contributing editor for CATster, andauthors a column called Steve Dale’s Vet World for Veterinary Practice News.
He also contributes blogs for various websites, including for Victoria Stilwell and the Pet Health Network.
On TV, he’s appeared on The Oprah Winfrey Show, National Geographic Explorer, Pets: Part of the Family(PBS), Fox News, various Animal Planet shows, and many others. For several years, Steve was a regular contributor to Superstation WGN-TV morning news, then appeared regularly on WMAQ-TV, Chicago. Currently, he’s a contributor to nationally syndicated HouseSmarts TV. Steve’s also a frequent host of satellite media tours.
In print, he’s been quoted in the Wall Street Journal, USA Today, Los Angeles Times, Redbook, various veterinary publications, and dozens more. He has also appeared as an expert guest on countless radio programs.
Steve co-edited Decoding Your Dog, written by the American College of Veterinary Behaviorists (Houghton Mifflin Harcourt, 2014). Steve’s the author of ebooks, Good Dog! and Good Cat! (Chicago Tribune, 2013). He’s the author of several other books, including DogGone Chicago and American Zoos.
He’s written introductions or contributed chapters and forewords to many books, including Bonding With Your Dog, Dog Spelled Backwards, The Compassion of Dogs, Raising My Furry Children, Christmas Cats, and Angel Animals and the Kids Who Love Them.
Steve was an external reviewer for the 2005 Feline Behavior Guidelines (American Association of Feline Practitioners) and is a contributor to textbooks “The Cat: Clinical Medicine and Management” (edited Dr. Susan Little, 2011) and “Treatment and Care of the Geriatric Veterinary Patient” (edited Dr. Mary Gardner and Dr. Dani McVety, 2017).
He’s the primary author of the CATegorical Care: An Owner’s Guide to America’s Number #1 Companion (reviewers include AVMA, SAWA), published American Humane Association/CATalyst Council, 2010). He co-authored (with Dr. Sagi Denenberg) the American Veterinary Society of Animal Behavior Position Statement on Breed-Specific Legislation (2014).
Steve is a founder of the CATalyst Council and served on the Board of Directors from 2008 to 2012. He’s also on the Board of Directors of the Winn Feline Foundation (2007 to present), and Tree House Humane Society in Chicago (2005 to 2016). In 2012, after six years, he cycled off the Board of the American Humane Association and served as a National Ambassador. He’s an Advisory Board Member SPCA Puerto Vallarta (2016 to present),
Steve is also a part of an AVMA/AAHA initiative to encourage preventive care veterinary care, called Partners for Health Pets. In 2014, Steve co-founded Veterinary Professionals Against Puppy Mills. Steve is on the Pet Partners Human-Animal Bond National Advisory Board (2015 to present); National Advisory Board Member Angel on a Leash (2005 to 2016); National Fear Free Advisory Board (2013 to present); Task Force on Feline Sterilization (2015-present).
In Chicago, Steve created the Chicago Task Force on Companion Animals and Public Safety (2000-2010), where three-times proposed breed bans were over-turned and twice over-turned proposed mandated pediatric spay/neuter, as well as proposed pet limit laws. The Task Force also created guidelines for ‘doggy day care.’ As a pet advocate, Steve has testified many times against breed specific bans, pet limit laws, etc. Steve personally advised Illinois Governor Pat Quinn regarding pet-related issues.
Among Steve’s many awards, the AVMA Humane Award (the only AVMA honor bestowed to a non-veterinarian), Editor and Publisher syndicated newspaper Feature Writer of the Year Award, AKC Responsible Dog Ownership Public Service Award, HSUS Pets for Life Award, and has been honored with over 15 Maxwell’s Awards from the Dog Writer’s Association of America and over 15 Muse Awards from the Cat Writers’ Association of America. He’s also been honored by the Chicago Veterinary Medical Association, University of Illinois College of Veterinary Medicine, and was the first recipient of the Winn Feline Foundation Media Appreciation Award, and many others.
In 2012, Steve became the youngest person ever inducted into the Dog Writer’s Association of America Hall of Fame.
After his beloved cat Ricky passed away in 2002 of feline hypertrophic cardiomyopathy (HCM), Steve created a fund to raise money to research this often-fatal disease. He’s raised well over $100,000 – and as a direct result a genetic test was created to determine if a gene defect for HCM exists for two breeds.
Steve’s a regular speaker at veterinary and shelter conferences around the world, and for shelter fundraisers, and other special events. Steve’s presented at each of the major U.S. veterinary conferences (numerous times), and at state and regional meetings as well as veterinary schools, and several times for the International Association of Animal Behavior Consultants. He’s also spoken at the World Small Animal Veterinary Association Conference (Sydney, Australia), Latin American Veterinary Conference (Lima, Peru), Congreso Veterinario de Leon (Leon, Mexico) Caribbean Veterinary Conference (Sr. Kitts) and others.
Steve’s persistence convinced the Chicago White Sox to allow dogs at a major league baseball game – today, ball parks around America have periodic “dog days” promotions. In 2004, he suggested Mercury Skyline Cruiseline create “The Canine Cruise,” a dog-friendly architecture cruise for dogs on Lake Michigan/Chicago River, also replicated in other cities.
Steve is also the host (since 2015) of a popular WGN Podcast,Steve Dale’s Other World(about topics generally unrelated to pets).
Two of Steve’s favorite honors: Commencement Speaker at Madison Square Garden for Ross University School of Veterinary Medicine (2008), and appearing (in 2012) as 59 across in a TV Guide Crossword Puzzle (pet journalist Steve _ _ _ _).
Transcript:
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Announcer: Let's talk pets!
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Dr. Kathryn Primmm: Hey there, cat lovers, welcome to Nine Lives with Dr.
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Dr. Kathryn Primmm: Kat.
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Dr. Kathryn Primmm: I'm your host, Dr.
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Dr. Kathryn Primmm: Kathryn Primmm, and of course, I'm a small animal veterinarian, and this is the go-to podcast for the latest news and updates in cat care.
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Dr. Kathryn Primmm: So I'd like to talk about something today that is exciting to me on the front of FIP, and we've talked about FIP, feline infectious peritonitis, before, but there are some new things we wanna learn and because this disease is so serious and so important.
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Dr. Kathryn Primmm: That is the reason that I have Steve Dale with me today.
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Dr. Kathryn Primmm: Steve has FIP concerns as one of his pet projects, if you will, and he's made a point to educate and inform everyone about this disease.
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Dr. Kathryn Primmm: So I am very excited to take a quick break and then come back with Steve and find out everything we need to know right now about FIP.
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Dr. Kathryn Primmm: We'll be right back.
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Dr. Kathryn Primmm: Hey there, cat lovers, this is Dr.
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Dr. Kathryn Primmm: Kat from Nine Lives with Dr.
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Dr. Kathryn Primmm: Kat.
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Dr. Kathryn Primmm: Did you know that there are an estimated 70 to 100 million free roaming cats in the United States?
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Dr. Kathryn Primmm: And without spay and neuter, that number is just going to keep growing.
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Dr. Kathryn Primmm: Not only does spaying and neutering humanely reduce the community cat population, but it also keeps cats healthier.
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Dr. Kathryn Primmm: Scooter, the neutered cat, is on a mission to give cats an extra life by making it hip to be snipped..
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Dr. Kathryn Primmm: Visit his website, givethemten.org, to help pioneer a better world for cats.
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Dr. Kathryn Primmm: That's GiveThemTen, spelled out, T-E-N, dot org.
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Dr. Kathryn Primmm: Well, Nine Lives are great, but let's add another one and give them ten.
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Announcer: Let's Talk Pets on petliferadio.com.
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Dr. Kathryn Primmm: Welcome back to Nine Lives with Dr.
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Dr. Kathryn Primmm: Kat on Pet Life Radio.
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Dr. Kathryn Primmm: As I mentioned before, I have Steve Dale.
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Dr. Kathryn Primmm: Welcome back, Steve.
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Steve Dale: Oh, it's always good to talk to you, Dr.
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Steve Dale: Primmm.
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Steve Dale: Thank you.
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Dr. Kathryn Primmm: You're welcome.
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Dr. Kathryn Primmm: It's fun.
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Dr. Kathryn Primmm: Now, many of my listeners are familiar with you because you've been with us before.
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Dr. Kathryn Primmm: But for those that are just becoming acquainted with you, can you give us a quick bio about who you are and what you do?
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Dr. Kathryn Primmm: Because it's pretty fun.
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Steve Dale: I'm a certified animal behavior consultant.
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Steve Dale: I host various radio shows about pets.
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Steve Dale: I appear on television.
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Steve Dale: I've contributed to or have authored pet books.
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Steve Dale: And I am most, I think, relevant to this conversation.
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Steve Dale: I've been a board member of the Wynn Feline Foundation for, I don't know, about 15 years or so.
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Steve Dale: Clearly, they need better term limits or something.
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Steve Dale: And incidentally, that same nonprofit is now called the Every Cat Health Foundation, same organization, same mission, which is to fund cat health studies.
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Steve Dale: So pretty much, Dr.
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Steve Dale: Primm, almost everything you do, every day, regarding cats and cat health, the cat comes in and you say, Oh my gosh, this cat has diabetes.
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Steve Dale: Or, Oh my gosh, this cat, I believe, is in stage two renal failure or has kidney disease.
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Steve Dale: All of that information and so much more was once funded by this organization called the Every Cat Health Foundation, a nonprofit.
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Steve Dale: But part of our mission is to educate, which is about what we're about to do today.
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Dr. Kathryn Primmm: That is wonderful.
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Dr. Kathryn Primmm: So just to kind of kick this off, historically, feline infectious peritonitis has been kind of a grim disease because there were limited effective treatments and the Every Cat Foundation really stepped up to help us get a handle on that.
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Dr. Kathryn Primmm: And so, Steve, let's give my listeners a little bit of a history, because it's sort of interesting how this all came about.
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Dr. Kathryn Primmm: Let's give them a history lesson about FIP.
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Steve Dale: I think that is interesting, and I think it's important.
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Steve Dale: It's also complicated.
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Steve Dale: So going way back in time, decades and decades ago, we knew that kittens Primmarily were talking kittens, but not exclusively kittens.
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Steve Dale: We're dying of something that wasn't even identified yet, and eventually called feline infectious peritonitis.
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Steve Dale: But the disease process, it took years to understand.
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Steve Dale: And here's why.
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Steve Dale: It turns out kittens who get the coronavirus, which is not uncommon, they get the coronavirus, the feline coronavirus, no chance of human beings getting this coronavirus.
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Steve Dale: They get this coronavirus through exposure of other kittens or other cat species.
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Steve Dale: The thing is, by the time they call you, Dr.
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Steve Dale: Primm, and say, my kitten isn't acting quite right, and usually the sign is runny stool or an upset tummy in one shape or form, and kittens, by the time you call back, the kitten is fine.
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Steve Dale: It is pretty much, and I like your take on this, if you disagree, but it is pretty much in of itself a benign virus in cats, not necessarily if we recently have found out in people, but in cats, it really is not an issue.
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Steve Dale: Has that been your experience?
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Dr. Kathryn Primmm: It has, but you know what?
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Dr. Kathryn Primmm: When it is an issue, it's an issue.
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Dr. Kathryn Primmm: It's a really big issue, and it's just kind of sad and a bit devastating, but I do think that it is important and interesting to point out that it's a coronavirus, which we've all heard about and talked about, you know, as of the last few years.
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Dr. Kathryn Primmm: So, yeah, I would say it's not a thing until it's a thing.
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Steve Dale: And when it becomes a thing is when inside the cat, for reasons we still do not understand, this otherwise benign or greatly benign coronavirus transforms into an immune-mediated disease, something entirely different, and that is called feline infectious peritonitis, or FIP, which had always been considered fatal.
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Steve Dale: And in about 2017 or so, Dr.
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Steve Dale: Niels Petersen, University of California Davis, now emeritus, he's now retired, and he's done so much in the realm of feline infectious disease, not only in helping us to better understand FIP, but also in the world of dogs, to help us better understand and treat brachiocephalic dogs, for example.
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Steve Dale: But in the cat world, he has made such an enormous difference, and he came to us, our board, and he said, I think I've got it.
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Steve Dale: I think I've got a drug that had been used greatly ineffectively for humans with Ebola virus that he thought could help these kittens with FIP.
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Steve Dale: And he went to the pharmaceutical company Gilead, and they gave him permission to use the drug, but he needed funding to do a clinical trial.
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Steve Dale: And we looked at, or our experts, who understand the chemistry of these things way better than I do, looked at the composition of that drug and said, yes, that drug might potentially, let's try it, do the trick.
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Steve Dale: And after all, we are talking about a disease that's fatal.
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Steve Dale: So the worst thing that can happen is the disease will continue to be fatal, but it made sense that this drug might help.
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Steve Dale: Might help?
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Steve Dale: It turned out to cure these kittens.
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Steve Dale: No one even expected that.
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Steve Dale: Yes, there were some and some kitten side effects, but by gosh, you're talking about a life-threatening drug.
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Steve Dale: A life-threatening disease that is now being cured, and the study was replicated again with great success.
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Steve Dale: Then the pharmaceutical company, which is going to be a part of the story, pulled or prevented the ability to continue use for cats.
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Steve Dale: So, now we know the composition of the drug, so experts said we can replicate this.
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Steve Dale: They did, and that replication of that drug was even better.
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Steve Dale: So, that's where we are in 2019, when the nonprofit organization that funded all this brought people together from all over the world, people who at one time or another in their career were funded by this organization, including Dr.
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Steve Dale: Peterson at UC Davis, to better understand FIP.
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Steve Dale: Dr.
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Steve Dale: Peterson led this entire symposium, and at that symposium, I'm the dude who had the honor of standing up there and saying, based on what all the experts, and indeed experts, that's the right word, all these experts in the room have said, FIP is now considered treatable and is no longer considered fatal.
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Steve Dale: And textbooks from here on out will change that terminology, will note which antiviral drug can work.
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Steve Dale: And in fact, based on that meeting, an effort was made that is still being made now that I'll talk about to get R in the US., Food and Drug Administration, Center for Veterinary Medicine to approve that drug.
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Steve Dale: Well, when I made the announcement, Dr.
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Steve Dale: Primm, I mean, imagine making that announcement.
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Steve Dale: And I look to my right, I remember exactly where Dr.
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Steve Dale: Elizabeth Cullinan was seated, and I know she was a guest previously on your show, talking about FIP.
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Steve Dale: And tears were just streaming down her face.
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Steve Dale: And I mean, you tell me, is there anything worse than communicating previously to a cat parent that your little kitten has this disease that I can't do a thing about?
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Dr. Kathryn Primmm: You know, I was just about to say that there are not that many infectious diseases in cats where we say, this is 100% fatal.
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Dr. Kathryn Primmm: And these are kittens, a lot of times, that people are so excited about.
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Dr. Kathryn Primmm: They've gone to the shelter, they've picked out this kitten, they were so happily buying toys and litter boxes and kitten beds, and I have to tell them this.
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Dr. Kathryn Primmm: And so this has been a huge thing, and that's why I wanted to have you on the show, because veterinarians were so sad about this and new kitten parents were so sad, and this is just a game changer, it's so important.
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Steve Dale: Well, you're right, except the game changer began to occur more quickly in other countries than America.
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Steve Dale: And for reasons I can't explain, the pharmaceutical company refused to release their version of the drug.
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Steve Dale: By the way, one thing happened, and that was the pandemic.
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Steve Dale: And that's a part of the story.
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Steve Dale: So the human coronavirus, I mean, we get coronaviruses, we have for decades and decades and decades, hundreds of years that we call the common cold.
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Steve Dale: But this new novel coronavirus comes about, creates a pandemic on the planet.
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Steve Dale: Our physicians, desperate to try anything, saw the scientific papers, we believe, from Dr.
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Steve Dale: Peterson that we funded, and said, well, I know human beings are not cats.
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Steve Dale: FIP isn't even directly, it's related to a coronavirus.
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Steve Dale: It stems from a coronavirus, but it in itself isn't.
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Steve Dale: But still, let's give it all a try.
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Steve Dale: And they did, and that drug called Remdesivir has helped now, and that drug wouldn't have been used if it wasn't for our organization saying, hey, let's try it.
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Steve Dale: Dr.
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Steve Dale: Peterson in the first place saying, this might work, which it turned out to work.
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Steve Dale: And now that same drug Remdesivir had been used, I don't know, hundreds of thousands of times to help save lives on our planet for people who otherwise may have passed away from the coronavirus, the human coronavirus that caused COVID-19.
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Steve Dale: So that's actually a part of the story too.
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Steve Dale: I mean, it's this long, crazy story, which continues this way.
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Steve Dale: So other nations began to approve the drug or similar drugs, because once you know the compound, apparently you can create something.
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Steve Dale: I'm not a pharmacist or a chemist, but can create things that do work.
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Steve Dale: And that did happen.
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Steve Dale: But not in America.
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Steve Dale: Our US Food and Drug Administration, as I said, the pharmaceutical company wouldn't say, okay, you can use this on cats.
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Steve Dale: They prevented release of their drug, remdesivir, and for cats.
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Steve Dale: Now it can be used by the way, but I'll talk about that if you like.
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Steve Dale: But at the same time, our US Food and Drug Administration wasn't saying it's okay to use any of these compounds.
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Steve Dale: So China saw the need.
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Steve Dale: China saw the need, came in through the so-called black market and offered a drug or two or three available on the black market for kittens with FIP.
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Steve Dale: Well, as it turned out, there was early skepticism, of course.
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Steve Dale: I mean, this is technically illegal.
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Steve Dale: How can veterinarians prescribe it?
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Steve Dale: And incidentally, they can't, you can't.
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Steve Dale: But I would argue you can help support these kittens, but can you even promote these websites that offer availability to these products?
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Steve Dale: Well, it turns out now two published, peer-reviewed studies have been done to indicate, I don't remember the exact number, but it's over 85%, somewhere in there, of these kittens are, as far as we know, cured.
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Steve Dale: A word that is, I use hesitantly, but it seems that's the case.
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Steve Dale: So the drugs do work, but do you know for sure what you're getting from China?
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Steve Dale: You don't.
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Steve Dale: Do you know for sure it will arrive when it's supposed to?
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Steve Dale: You don't.
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Steve Dale: I mean, mostly, as I say, they do seem to work at the very beginning, exceedingly expensive.
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Steve Dale: They've come down in price, but still quite expensive.
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Steve Dale: I don't believe the pet insurance companies cover them.
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Steve Dale: And there's a squishy area that you can talk about better than me as to what veterinarians can do as far as these Chinese products.
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Steve Dale: I mean, you can still, and I believe, I'm no lawyer, but if you prescribe something, you are in violation of the Veterinary Practice Act and can lose your license.
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Steve Dale: Prescribe something that isn't prescribable, really, from China.
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Steve Dale: On the other hand, you could provide supportive care for these kittens, do follow-up, and do blood work to see how they're doing, provide additional pain relief if needed, all those sorts of things that are really important for these kitties, provide maybe some dietary advice, because they're so sick, they don't feel like eating, all of these things, but it's not ideal.
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Steve Dale: So you could talk about that part of this better than I, before we talk about the next step, which is where we are today.
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Dr. Kathryn Primmm: Well, yes, so that is a really good time to take a quick break, because it's pretty complicated, and I want to let everybody's brain sort of relax for just a minute.
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Dr. Kathryn Primmm: So we'll take a quick break, and we'll be right back.
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Dr. Kathryn Primmm: Let's talk pets.
00:16:46.080 --> 00:16:49.090
Dr. Kathryn Primmm: petliferadio.com Welcome back to Nine Lives with Dr.
00:16:49.110 --> 00:16:51.090
Dr. Kathryn Primmm: Kat on KatLife Radio.
00:16:51.490 --> 00:17:06.170
Dr. Kathryn Primmm: So Steve Dale and I are here discussing feline infectious peritonitis and the super interesting and convoluted history of how we got where we are, but I want to pick back up because where we are is actually way, way better than where we started.
00:17:06.390 --> 00:17:09.270
Dr. Kathryn Primmm: And there have been some recent changes.
00:17:09.610 --> 00:17:10.730
Dr. Kathryn Primmm: So Steve, pick back up.
00:17:10.830 --> 00:17:21.570
Dr. Kathryn Primmm: We had the Chinese scientists who saw the need to make this available for Kat's, and then meanwhile, all of the veterinarians here in the US are trying to support these cats and get the word out.
00:17:21.590 --> 00:17:23.750
Dr. Kathryn Primmm: So let's pick that story back up.
00:17:24.090 --> 00:17:30.890
Steve Dale: So the good news is these products from China seem to work, but there's no guarantee of what you're getting.
00:17:31.450 --> 00:17:37.770
Steve Dale: If you have a question or concern, depending on the Chinese company, you get iffy support.
00:17:38.050 --> 00:17:43.550
Steve Dale: And if you have a complaint, well, forget about it, because this is a Chinese company doing something under the table.
00:17:43.970 --> 00:17:48.130
Steve Dale: If you don't get the drug in the mail, like you're supposed to, what do you do about it?
00:17:48.710 --> 00:17:54.210
Steve Dale: It's an injectable that's difficult because it's a honking big injectable.
00:17:54.930 --> 00:17:58.910
Steve Dale: And the support you get from China isn't there.
00:17:58.930 --> 00:18:07.250
Steve Dale: Now, the good news is there is a Facebook page that does provide incredibly, incredibly wonderful support.
00:18:07.570 --> 00:18:09.430
Steve Dale: And there are other individuals out there.
00:18:09.430 --> 00:18:12.370
Steve Dale: And most veterinarians, I think Dr.
00:18:12.390 --> 00:18:20.410
Steve Dale: Primm today, will provide at first hesitant, not understanding like, how can I get into this, but providing supportive care.
00:18:20.690 --> 00:18:30.870
Steve Dale: So while you can't prescribe this black market drug, you can say, okay, go to the internet and find something, which people, you don't even need to tell them that.
00:18:31.170 --> 00:18:34.890
Steve Dale: I mean, generally, these clients are motivated to do that on their own anyway.
00:18:35.190 --> 00:18:41.910
Steve Dale: And they find a Facebook page that is hugely helpful to them, something 5.0, I'll think of it.
00:18:41.950 --> 00:18:44.570
Steve Dale: But FIP 5.0, that isn't quite right.
00:18:44.590 --> 00:18:45.130
Steve Dale: I can't...
00:18:45.150 --> 00:18:46.910
Dr. Kathryn Primmm: I think it's FIP Warriors.
00:18:46.930 --> 00:18:47.870
Steve Dale: Thank you.
00:18:48.770 --> 00:18:49.650
Steve Dale: Yay, thank you.
00:18:49.790 --> 00:18:50.670
Steve Dale: I just couldn't think of it.
00:18:51.390 --> 00:18:52.990
Steve Dale: And they do an amazing job.
00:18:53.010 --> 00:18:54.510
Steve Dale: So many feline veterinarians.
00:18:54.790 --> 00:18:55.810
Steve Dale: We've mentioned Dr.
00:18:55.830 --> 00:18:56.390
Steve Dale: Colloran.
00:18:56.410 --> 00:18:58.290
Steve Dale: She was a participant in that page.
00:18:58.670 --> 00:19:02.810
Steve Dale: I mean, there is help out there today, but it's not ideal.
00:19:03.090 --> 00:19:04.970
Steve Dale: So what has happened next?
00:19:05.330 --> 00:19:06.450
Steve Dale: Still not ideal.
00:19:07.230 --> 00:19:16.270
Steve Dale: Why America's lagging behind, I don't completely know, but it is closer, perhaps, perhaps to getting to the right place.
00:19:16.550 --> 00:19:27.810
Steve Dale: So there is a compounded drug that is now available from Stokes Pharmacy, created the drug in part by the Bova Group.
00:19:28.410 --> 00:19:33.390
Steve Dale: It's a chewable, so it's not that injectable that is currently being used.
00:19:33.710 --> 00:19:45.450
Steve Dale: That chewable, the Bova Group is based in the UK, has been used there, and Australia, and I believe another country or two as well, though I'm not sure which ones are not even sure of that.
00:19:45.810 --> 00:20:00.010
Steve Dale: But I do know Stokes Pharmacy, based in New Jersey, said we are going to manufacture this product in the US, in New Jersey, we're gonna compound it, incidentally tasting like tuna.
00:20:00.370 --> 00:20:10.510
Steve Dale: And veterinarians in most states, not every state, incidentally, can support a compounded pharmaceutical, but the vast majority of states can.
00:20:10.990 --> 00:20:16.070
Steve Dale: So you have a client that comes in because you're in Tennessee, one of those states that can.
00:20:16.590 --> 00:20:19.810
Steve Dale: Sadly, you have to diagnose FIP in this kitty.
00:20:20.110 --> 00:20:27.790
Steve Dale: But now you can say, you don't have to beat around the bush and say, go to FIP Warriors 5.0, if even you wanna say that.
00:20:28.150 --> 00:20:33.290
Steve Dale: Now you can say, there is a compounded product, I can get it for you.
00:20:33.690 --> 00:20:38.710
Steve Dale: And therefore, obviously, provide supportive care for these kittens who need that.
00:20:38.950 --> 00:20:50.110
Steve Dale: They may need fluids, they may need other medication, advice to owners about all sorts of things, including how to get this compounded medication into the kitten.
00:20:50.110 --> 00:20:56.650
Steve Dale: So that's one thing I was quick to ask the CEO, actually, of Stokes Pharmacy about.
00:20:56.670 --> 00:20:57.970
Steve Dale: I've talked to him a couple of times.
00:20:58.550 --> 00:21:03.710
Steve Dale: Very nice man, I think, personally, he wants to do this for all the right reasons.
00:21:03.730 --> 00:21:16.130
Steve Dale: Of course, they're a for-profit organization, but still wants to do it for all the right reasons, to help these kitties in a place that is on the up and up, shall we say, and everything is above board.
00:21:16.150 --> 00:21:35.350
Steve Dale: So if a client has a question, the client and certainly the veterinarian can ask Stokes Pharmacy, who has one-to-one availability with veterinarians, you don't have that opportunity as a veterinary professional to pick up the phone and call China or email, China and say, what's going on?
00:21:35.670 --> 00:21:40.650
Steve Dale: And if you do, which you likely don't, what answer are you going to get?
00:21:40.950 --> 00:21:42.630
Steve Dale: How can you trust that answer?
00:21:42.950 --> 00:21:51.990
Steve Dale: This is a company that is respectable and that has to be trustworthy by law, actually, in America, according to our law.
00:21:52.350 --> 00:21:59.310
Dr. Kathryn Primmm: Okay, so it gets kind of complicated, and this is something that comes up in my practice a lot, not just about FIP, but about everything.
00:21:59.950 --> 00:22:06.870
Dr. Kathryn Primmm: And I was hoping you and I could just talk about it, about the FDA and regulation and drugs and federal prescription law.
00:22:07.170 --> 00:22:24.590
Dr. Kathryn Primmm: So you've touched upon the fact that there's no FDA-approved drug available to treat FIP, but the FDA, I guess, came out and said that they are not going to enforce the approval requirements that restricted us from using the compounded drugs.
00:22:25.050 --> 00:22:26.730
Dr. Kathryn Primmm: Can you expand on that just a little?
00:22:27.470 --> 00:22:35.490
Steve Dale: I think that from what I hear, the FDA is going to reword that statement because it made it seem as though this company is doing something that they shouldn't be doing.
00:22:35.870 --> 00:22:43.670
Steve Dale: If that were the case, I suspect they wouldn't be doing it because they're a large company and they're responsible to American laws.
00:22:44.110 --> 00:23:01.290
Steve Dale: So it is in most states, as I said, just fine for a company to say, we are compounding drug X, we are responsible for that compound chemical that we put together, we're responsible for that.
00:23:01.610 --> 00:23:07.050
Steve Dale: In this case, it is the FIP drug, and I want to get this right, it's a lot of letters and numbers.
00:23:07.530 --> 00:23:15.790
Steve Dale: It's GS441524, because there's a couple out there with different letters and numbers for FIP.
00:23:15.970 --> 00:23:17.630
Steve Dale: Yes, it's complicated.
00:23:17.970 --> 00:23:21.950
Steve Dale: The bottom line is that everything isn't for everybody.
00:23:22.550 --> 00:23:32.410
Steve Dale: And there are individuals who, for whatever the reason, may want to continue for the time being with these Chinese black market companies.
00:23:32.750 --> 00:23:37.030
Steve Dale: And again, 85% plus success rate.
00:23:37.490 --> 00:23:47.230
Steve Dale: I don't know the percent success rate, because it's only been out there since June 1st in America of this other product, the compounded product.
00:23:47.390 --> 00:23:53.790
Steve Dale: I do know that in the UK and in Australia, they had some success with it for sure.
00:23:54.170 --> 00:23:59.350
Steve Dale: I don't know what that success rate is, but I do know it is approved in both those places.
00:23:59.870 --> 00:24:02.510
Steve Dale: It is not unapproved in America.
00:24:03.130 --> 00:24:07.130
Steve Dale: And a veterinarian can, and not only for this drug.
00:24:07.210 --> 00:24:09.070
Steve Dale: There's another issue, though, too, though.
00:24:09.530 --> 00:24:16.130
Steve Dale: The Chinese are now infiltrating the American marketplace on the human side as well, I'm told.
00:24:16.590 --> 00:24:28.110
Steve Dale: But I know on the animal side, with, for example, a heart drug for feline hypertrophic cardiomyopathy, that I don't know that it's taken off, and I don't want to talk too much about it.
00:24:28.130 --> 00:24:29.250
Steve Dale: I don't want it to take off.
00:24:29.510 --> 00:24:33.010
Steve Dale: I don't know anything about it, and that's part of the problem.
00:24:33.030 --> 00:24:41.830
Steve Dale: So pet parents that are desperate, or humans that are desperate for themselves, will see something online now increasingly from China.
00:24:42.130 --> 00:25:05.210
Steve Dale: So my guess, and it's just Steve Dale's guess, all it is, a guess, that America will be more strict about allowing anything at some point, any drugs into America from China, except those that go directly to pharmaceutical companies or are vitamins that we get from China, et cetera.
00:25:05.550 --> 00:25:10.050
Steve Dale: But this kind of thing I think will be a crackdown on is my guess.
00:25:10.330 --> 00:25:13.130
Steve Dale: Let me get back to what this is.
00:25:13.170 --> 00:25:14.450
Steve Dale: It's a chewable.
00:25:15.130 --> 00:25:17.730
Steve Dale: It's for nearly every cat with FIP.
00:25:18.310 --> 00:25:19.950
Steve Dale: The chewable tastes like tuna.
00:25:20.350 --> 00:25:23.390
Steve Dale: But as you know, you can give a healthy cat.
00:25:23.870 --> 00:25:28.190
Steve Dale: Our cat, Groucho, who's around somewhere, is about two years old.
00:25:28.570 --> 00:25:32.190
Steve Dale: I potentially, I think Groucho would scarf down anything, but I don't know.
00:25:32.750 --> 00:25:39.270
Steve Dale: I could give him this chewable, and it's obviously not advised for a healthy cat, please.
00:25:39.690 --> 00:25:49.150
Steve Dale: But my point is you can give a cat something novel, or try to is the point, and that cat's gonna turn up his nose or her nose on it, just because it's novel at times.
00:25:49.370 --> 00:25:55.770
Steve Dale: On top of everything else, these kittens are very sick, and greatly, they don't have an appetite.
00:25:56.010 --> 00:25:59.810
Steve Dale: So how do you get this into the cat?
00:26:00.030 --> 00:26:03.570
Steve Dale: There are some tricks of the trade that veterinarians know.
00:26:03.890 --> 00:26:10.310
Steve Dale: There are some tricks of the trade that Stokes Pharmacy says they know that they're going to help pet parents with.
00:26:10.770 --> 00:26:21.450
Steve Dale: But having said that, for some individuals who may be unable to pill any cat or to get anything in any cat, again, this is chewable.
00:26:21.470 --> 00:26:25.070
Steve Dale: You shouldn't have to pill, but how else can you do it for some of these kittens?
00:26:25.290 --> 00:26:34.050
Steve Dale: So not everything is right for everybody, and only time will tell for sure what is going to fly and what isn't going to fly.
00:26:34.390 --> 00:26:36.790
Steve Dale: Also, I'm not aware yet of the price point.
00:26:37.790 --> 00:26:43.470
Steve Dale: I am aware, according to Stokes, that Trupanion Pet Insurance will cover this.
00:26:43.970 --> 00:26:50.090
Steve Dale: Now, I don't believe they'll cover it if your kitten's diagnosed with FIP, and then you go to the insurance company.
00:26:50.110 --> 00:26:52.230
Steve Dale: It's just like going to a human insurance company.
00:26:52.510 --> 00:26:59.910
Steve Dale: Once you've got, I don't know, leukemia, God forbid, and say, cover me, you know, they're not going to cover after the fact.
00:27:00.270 --> 00:27:07.950
Steve Dale: However, if the kitten gets pet insurance first, and then FIP has later discovered, I'm told, trupanion will cover.
00:27:08.890 --> 00:27:10.490
Steve Dale: So that is a plus.
00:27:10.850 --> 00:27:16.490
Steve Dale: The biggest plus of all, in theory, is the support factor that you wouldn't get from a Chinese company.
00:27:17.330 --> 00:27:31.530
Dr. Kathryn Primmm: I want to highlight the importance of the veterinarian, because this is out there, it's out there on social media, and it's out there on websites, but you can't go it alone, because your veterinarian's got to make this diagnosis and guide you and provide supportive care.
00:27:31.770 --> 00:27:40.050
Dr. Kathryn Primmm: If anybody out there is listening, and they have received a diagnosis of FIP for their cat, this is very, very valuable information.
00:27:40.070 --> 00:27:57.650
Dr. Kathryn Primmm: If anybody out there is listening and looking at their kitten and thinking, huh, you're losing weight, and you are not doing quite right, and you may have abdominal swelling, whatever, go to your veterinarian, because this information has to benefit you with your veterinarian.
00:27:57.670 --> 00:27:58.630
Steve Dale: I agree.
00:27:58.650 --> 00:27:59.930
Steve Dale: It's a team effort.
00:28:00.450 --> 00:28:23.710
Steve Dale: And while veterinarians can, in my non-legal view, provide supportive care, I don't think that any state licensing is going to come in and say, well, you're providing blood work and fluids and advice for this kitten with FIP, even though the kitten is getting drugs from China and take away anyone's license.
00:28:23.930 --> 00:28:28.470
Steve Dale: I don't see, in my non-legal opinion, that happening.
00:28:28.490 --> 00:28:30.210
Steve Dale: And to my knowledge, it has not happened.
00:28:30.370 --> 00:28:34.970
Steve Dale: Having said that, the way in which it's occurring now is not ideal.
00:28:35.230 --> 00:28:55.570
Steve Dale: And I will tell you that what we're all waiting for, and I will say, I believe, including Stokes Pharmacy, is for the US Food and Drug Administration Center for Veterinary Medicine to say, okay, company X, and I know which company they're looking at, company, but I'll call it company X for now, I suppose.
00:28:56.270 --> 00:29:00.270
Steve Dale: Company X, what you put in now like three years ago.
00:29:00.570 --> 00:29:11.350
Steve Dale: I think we will see the FIP drug approved as an injectable and maybe also a pill in America, but I don't think it's gonna happen this year or next year.
00:29:11.390 --> 00:29:12.850
Steve Dale: Maybe, maybe not next year.
00:29:13.070 --> 00:29:22.370
Steve Dale: Again, why it's taking so long in part, it's because it could have been made a whole lot easier if Gilead released their product, Remdesivir.
00:29:22.730 --> 00:29:30.210
Steve Dale: Remdesivir can now be used off label in cats, but how do you know what the dose is for cats?
00:29:30.430 --> 00:29:35.130
Steve Dale: You could look at what Australia is doing with Remdesivir as a veterinarian, Dr.
00:29:35.150 --> 00:29:35.430
Steve Dale: Primm.
00:29:35.450 --> 00:29:37.570
Steve Dale: On the other hand, how do you even get it?
00:29:38.330 --> 00:29:40.310
Steve Dale: And it's hugely expensive.
00:29:40.830 --> 00:29:43.930
Steve Dale: So that is not a practical solution.
00:29:43.950 --> 00:29:50.030
Steve Dale: I don't know that it's been done much, if at all, in America because it is so impractical.
00:29:50.270 --> 00:29:52.610
Steve Dale: So that company has made it very difficult.
00:29:52.910 --> 00:29:55.330
Steve Dale: That's their right, I suppose.
00:29:56.270 --> 00:29:58.870
Steve Dale: Letters have been written and all the rest, they don't seem to care.
00:29:59.570 --> 00:30:00.690
Steve Dale: They're a big pharma company.
00:30:00.710 --> 00:30:01.450
Steve Dale: What can I say?
00:30:01.630 --> 00:30:03.110
Steve Dale: They can change their mind tomorrow.
00:30:03.430 --> 00:30:04.270
Steve Dale: That would be nice.
00:30:04.450 --> 00:30:12.830
Steve Dale: But in the meantime, we have another company with another product that we, I believe, I know, based on what I know, will work.
00:30:12.850 --> 00:30:16.970
Steve Dale: It's just a matter of the FDA approving why they're dragging their paws.
00:30:17.370 --> 00:30:18.350
Steve Dale: I can't comment.
00:30:18.350 --> 00:30:19.110
Steve Dale: I have no clue.
00:30:19.350 --> 00:30:20.630
Dr. Kathryn Primmm: It's very complicated.
00:30:20.890 --> 00:30:22.710
Dr. Kathryn Primmm: It's always very complicated.
00:30:22.950 --> 00:30:23.730
Dr. Kathryn Primmm: And that's the thing.
00:30:23.750 --> 00:30:24.930
Dr. Kathryn Primmm: I want this to be easy.
00:30:25.130 --> 00:30:28.370
Dr. Kathryn Primmm: I want my kitten owners to be able to say, okay, Dr.
00:30:28.390 --> 00:30:29.570
Dr. Kathryn Primmm: Primm, this is your diagnosis.
00:30:29.590 --> 00:30:30.490
Dr. Kathryn Primmm: What are we going to do?
00:30:30.510 --> 00:30:32.170
Dr. Kathryn Primmm: And I want to be able to say, here it is.
00:30:32.390 --> 00:30:33.530
Dr. Kathryn Primmm: And this is what we're going to do.
00:30:33.550 --> 00:30:34.850
Dr. Kathryn Primmm: And this is what it's going to cost.
00:30:35.070 --> 00:30:38.410
Dr. Kathryn Primmm: And that's the day I am waiting for.
00:30:38.430 --> 00:30:41.070
Dr. Kathryn Primmm: This has been so incredibly informative.
00:30:41.410 --> 00:30:46.230
Dr. Kathryn Primmm: As we wrap up, I just want to highlight that the landscape of FIP is really changing.
00:30:46.650 --> 00:30:48.470
Dr. Kathryn Primmm: I mean, we still have hurdles to overcome.
00:30:48.490 --> 00:30:56.930
Dr. Kathryn Primmm: But it's getting better thanks to EveryCat and all the amazing minds that care about this issue, and you, and you, Steve Dale.
00:30:57.210 --> 00:30:57.890
Dr. Kathryn Primmm: Thanks to you.
00:30:57.910 --> 00:30:59.590
Steve Dale: Oh, I don't know.
00:30:59.650 --> 00:31:01.610
Steve Dale: It's really the EveryCat Health Foundation.
00:31:01.630 --> 00:31:06.450
Steve Dale: And to learn more and to keep up to date on this, to follow webinars we'll be presenting.
00:31:06.590 --> 00:31:08.910
Steve Dale: It's everycat.org.
00:31:09.170 --> 00:31:13.350
Steve Dale: Or you can check me out at simply stevedale.tv.
00:31:13.570 --> 00:31:18.810
Steve Dale: I've spoken to veterinary professionals, not only at that 2019 meeting, but many times about FIP.
00:31:19.190 --> 00:31:29.150
Steve Dale: And early on, when veterinarians didn't know that there is a solution, albeit from China at the time in America, every time I'd look up, tears in the eyes.
00:31:29.150 --> 00:31:36.530
Steve Dale: I mean, veterinarians don't want to, believe me, don't want to say your kitten has FIP.
00:31:36.670 --> 00:31:42.350
Steve Dale: Because mostly it is kittens, as you described earlier, previously considered fatal.
00:31:42.750 --> 00:31:52.310
Steve Dale: And that's the hardest thing for a veterinary professional to do as well, particularly when that family might have gotten that new kitten because they're already mourning a cat that passed away.
00:31:52.650 --> 00:31:53.810
Steve Dale: It's just, it's horrible.
00:31:54.710 --> 00:31:55.350
Dr. Kathryn Primmm: Agreed.
00:31:55.710 --> 00:31:58.470
Dr. Kathryn Primmm: Well, thank you for joining me today.
00:31:58.490 --> 00:32:03.690
Dr. Kathryn Primmm: It's always fun to talk to you because you're an easy guest and you always know the answer.
00:32:03.710 --> 00:32:04.910
Dr. Kathryn Primmm: So thank you so much.
00:32:05.510 --> 00:32:09.050
Steve Dale: I don't always, I wish I always knew the answers, but they do say I'm easy.
00:32:09.150 --> 00:32:11.210
Steve Dale: You're right about that.
00:32:11.230 --> 00:32:12.390
Dr. Kathryn Primmm: Easy, but not cheap, right?
00:32:14.070 --> 00:32:14.650
Steve Dale: Exactly.
00:32:14.850 --> 00:32:18.630
Dr. Kathryn Primmm: Well, thanks to my listeners for tuning in to Nine Lives with Dr.
00:32:18.650 --> 00:32:18.970
Dr. Kathryn Primmm: Kat.
00:32:19.150 --> 00:32:28.030
Dr. Kathryn Primmm: If you found this episode helpful, please share it with your fellow cat lovers and subscribe for more updates on caring for cats in the best possible way.
00:32:28.290 --> 00:32:30.970
Dr. Kathryn Primmm: Thanks to my producer, Mark Winter.
00:32:31.190 --> 00:32:32.190
Dr. Kathryn Primmm: Couldn't do it without him.
00:32:32.430 --> 00:32:33.010
Dr. Kathryn Primmm: I'm Dr.
00:32:33.030 --> 00:32:33.410
Dr. Kathryn Primmm: Kat.
00:32:33.530 --> 00:32:34.730
Dr. Kathryn Primmm: We'll see you next time.
00:32:34.810 --> 00:32:37.170
Dr. Kathryn Primmm: Go out and have a purrfect day.
00:32:37.770 --> 00:32:40.830
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00:32:41.210 --> 00:32:43.750
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