Inappropriate Use of GS-441524 in an Attempt to Eliminate Feline Enteric Coronavirus (FECV) from healthy cats

“Niels C. Pedersen, DVM PhD
Distinguished Professor Emeritus
University of California, Davis”

Mutian, the first Chinese company to sell GS-441524 on the unapproved market, has recently advertised that using its oral formulation for one (or more?) day will stop feline coronavirus (i.e., FECV) fecal shedding by healthy cats. Certain veterinary researchers are also advocating such an approach. The rationale is to prevent the appearance of FIP-causing mutant virus (FIPV) and thus prevent FIP. Although this approach is attractive at first consideration, it is a greatly misguided use of GS-441524 in cats. Currently, GS-441524 has only been recommended for treating cats suffering from FIP. The problems with this approach are many.

Mutian implies in their advertisements that FECV can be easily eliminated using a simple treatment with their oral formulation of GS-441524. They make no mention, however, of the research, if any, that led to this approach. No published field research proves whether chronic FECV shedding by healthy cats, 40% or more of individuals in any multi-cat population, can be permanently cured. Naturally occurring FECV infection occurs initially in kittens and is not associated with any notable disease signs. Shedding sometimes lasts weeks, months, and indefinitely, but it will ultimately cease as immunity builds in most cats. However, antibody levels decrease once immunity occurs and shedding stops, and the cats become susceptible to infection again. This cycle of primary and secondary infections will occur in many cats throughout their lives. It is doubtful that GS-441524 treatment will lead to more permanent immunity than seen in nature. However, this would not be consequential if FECV was short-lived in the environment and not easily carried on people's clothing, litter, hair, and other fomites. FECV will survive for up to 2 weeks in the environment, and transmission on fomites has been well documented. Therefore, even if FECV shedders can be cured, the virus will easily return to the population. This has also been documented from isolating queens and early weaning their kittens, a similar strategy for preventing FECV infection.

Even though our current knowledge of FECV infection seriously questions this approach, there are equally and perhaps more compelling reasons not to treat healthy cats with GS-441525 or any other safe and effective antiviral in the future. It is unlikely that FECV shedding can be stopped for any length in a single or short time; treatment is insinuated and will undoubtedly require a longer period. When applied to many cats in a cattery, shelter, or foster/rescue, this will be extremely expensive.

The greatest single reason to resist this approach for FIP prevention, even if proven possible by vigorous peer-reviewed and published laboratory research, is the problem of drug resistance. We already know that some cats with naturally acquired FIP are infected with one or more strains of FIPV resistant to GS-441524. Our field trial with 31 cats found one infected with a strongly resistant virus. There is also laboratory research confirming the ease by which resistance can be induced in cell cultures. Drug resistance is also well known in viral diseases such as HIV/AIDS and hepatitis C virus-infected people. The fastest way to achieve drug resistance to any microbe, including viruses, is to overuse drugs where they are not needed. Our experience with animal bacteria and human viruses amply testifies to the problem of anti-microbial drug resistance. There is no question that widespread use of drugs like GS-441524 in large populations of healthy cats will lead to a positive selection of strains of FECV that are drug-resistant, either partially or completely. This resistance will also be seen in FIP-causing mutants (FIPVs) of FECV, making it impossible to use GS-441524 in more and more cats with FIP. Unfortunately, veterinary medicine does not have human medicine resources, or the profit incentives, for discovering, testing, and gaining approval for more and more drugs merely to circumvent acquired drug resistance.

I implore well-intentioned cat owners and researchers to reject the use of safe and effective antiviral drugs in this manner. I cannot do anything about greedy drug makers who put profits above proper science, common sense, and the concerns of owners of cats that suffer from FIP now or in the future. There is a common saying - "just because we can do it, does not mean we should." -N. C. Pedersen