Predictive factors associated with short-term mortality in cats with feline infectious peritonitis treated with remdesivir or GS-441524 or both.

Abstract

BACKGROUND: Although most cats with feline infectious peritonitis (FIP) respond to treatment with remdesivir or GS-441524 or both with uneventful clinical courses, some die despite treatment. OBJECTIVE: Identify predictive factors associated with short-term mortality in cats with FIP treated with IV remdesivir or PO GS-441524 or both. ANIMALS: A total of 108 client-owned cats with FIP. METHODS: Retrospective multicenter study using data collected from medical records. Factors associated with short-term mortality, defined as death within 84&#x2009;days, were identified. Univariate analysis a t-test, Mann-Whitney U test, or Fisher's exact test and multivariate logistic regression were performed to assess patient characteristics and clinicopathological variables between survivors and nonsurvivors. RESULTS: The short-term mortality rate was 12.0% (95% confidence interval [CI], 6.6%-19.7%). Univariate analysis identified plasma lactate dehydrogenase activity (LDH; P&#x2009;<&#x2009;.001) and bilirubin concentration (P&#x2009;=&#x2009;.001) as being significantly increased in nonsurvivors, whereas concentrations of albumin (P&#x2009;=&#x2009;.003), total protein (P&#x2009;=&#x2009;.03), sodium (P&#x2009;=&#x2009;.005), and potassium (P&#x2009;=&#x2009;.005) were significantly lower. Additionally, nonsurvivors were significantly less likely to be febrile (&#x2265;39.4&#xb0;C; P&#x2009;=&#x2009;.006). Of these variables, only plasma LDH activity &#x2265;323&#x2009;U/L, a cut-point determined by receiver operating characteristic curve analysis, was significantly associated with short-term mortality by multivariate analysis (odds ratio, 15.30; 95% CI, 1.18-198.00; P&#x2009;=&#x2009;.04). CONCLUSION: Increased plasma LDH activity might be useful for predicting short-term mortality, guiding monitoring, and establishing prognosis in cats with FIP.