Should cats sick with COVID-19 receive FIP treatment?

January 23, 2023

I was contacted by someone with 5 cats that became sick after one of their humans contracted COVID-19. The cats had fevers, sneezing, coughing and difficulty making sounds.  This person wanted to know if cats should be treated for COVID-19 infections. I asked Dr Pedersen and below is his response (shared with his permission).

[Dr Niels Pedersen] - Cats do get infected with the Covid19 virus and it either causes no illness or a mild and transient upper respiratory infection, much like a very mild case of feline herpesvirus. In rare cases, the disease in cats can be severe. In fact, the chances are that this group of cats is suffering from herpesvirus and not Covid19 coronavirus.  Veterinarians can test cats for feline herpesvirus infection by PCR, but there is no test that is available to veterinarians for Covid19 and human laboratories have refused to test cats for Covid19 using tests designed for humans.

In either infection, the cats are going to recover in 10-14 days with no or minimal treatment.  If the disease signs they are showing are due to Covid19 virus, they would respond to GS, but why treat them?  It would be like treating every person with a positive Covid19 PCR test with Remdesivir for 5 days at a cost of $2000.  Of course, cats are not as large and would not cost this much, but they would have to be subjected to daily injections for no reason. It is also likely that her veterinarian would not be able to access Remdesivir, as it is currently limited to hospital use for a certain group of patients.

In short, my recommendation would be to test a couple of the worse cases for feline herpesvirus and the chances are high that they will be positive.  If they test negative, there is a chance that they do have Covid19 virus infections, but in either case, the treatment would be the same. The cats should be rested, discharges frequently cleaned from eyes and noses, and antibiotics only used if the discharges become purulent, indicating secondary bacterial infection. Rarely, breathing problems, fever, and anorexia may occur indicating a secondary bacterial pneumonia and more aggressive symptomatic treatment. They will self-cure in 10-14 days.

The article below is posted on the Cornell Feline Health Center and answers many common questions about cats and Covid-19. The most important points are listed here but definitely read the entire article.

  • Humans cannot catch COVID-19 from their cats
  • Cats CAN catch COVID-19 from their humans
  • Cats seem to recover from the mild flu like symptoms of COVID-19 in 10-14 days without any medical intervention
  • Some cats may need supportive care for upper respiratory infections caused by COVID-19
  • There is no reason to treat cats infected with COVID-19 with GS441524 or Remdesivir because these drugs are expensive and cats will recover without treatment.

Frequently Asked Questions COVID-19 and Feline Health

We understand that during this difficult time, cat owners are concerned about how best to care for their feline friends and themselves. Our mission at the Cornell Feline Health Center is to respond to emerging feline health crises, and we feel that it is incumbent upon us to provide cat lovers with reliable information that is based upon scientific evidence and to support them through this rapidly evolving crisis.

It’s important to note that the recommendations of the scientific community are based upon best available data and in consideration of the potential risks and benefits of these recommendations. An excellent source of up-to-date information in this regard is the US Centers for Disease Control and Prevention (CDC) website, which provides comprehensive answers to a variety of questions related to COVID-19, including best practices for pet owners.

Very importantly, there is currently NO EVIDENCE that SARS-CoV-2 can be passed from cats to people, so there is no need for owners to do anything that would endanger the welfare of their cats (i.e. relinquish to a shelter or abandon them) even if a cat is diagnosed with COVID-19.

Scientists are continuing to research this disease, and the Cornell Feline Health Center will continue to update you with the latest information as it becomes available.

Are domestic cats susceptible to COVID-19?

Domestic cats do seem to be susceptible to infection by SARS-CoV-2, the virus that causes COVID-19, although not highly susceptible. This conclusion is based upon the identification of three naturally occurring infections in cats (one in Belgium and two in the United States, see below), the identification of antibodies against the virus in some cats in China, and upon the results of a study in which cats were experimentally infected with SARS-CoV-2. The interpretation of the results and of the application of the results of this study to real-world situations are currently the subject of debate.

On April 22, The U.S. Centers for Disease Control and Prevention (CDC) and the United States Department of Agriculture’s (USDA) National Veterinary Services Laboratories (NVSL) announced the first confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) infection in two pet cats. These are the first pets in the United States to test positive for SARS-CoV-2.

Learn more about recent SARS-CoV-2 studies: Domestic Animal Susceptibility to SARS-CoV-2

Learn more about the two cats in New York

What effect does COVID-19 have on cats?

Cats appear to be at least mildly susceptible to COVID-19. The severity of disease caused SARS-CoV-2 infection in cats is unclear. In the naturally occurring case of feline COVID-19 from Belgium, the cat developed GI and respiratory problems and recovered within nine days. In the two cats from New York, both had mild respiratory illness and are expected to make a full recovery. In addition, the experimentally infected cats did not show evidence of virus in their lungs, but rather in their upper airways, and they did not develop signs of disease.

How can a cat become infected with SARS-CoV-2?

With respect to the potential sources of SARS-CoV-2 infection, available data suggests that the cat in Belgium was infected by its owner, and the study in which cats were experimentally infected with SARS-CoV-2 suggested that cat-to-cat transmission is possible. Based upon these findings, transmission from people to cats and from cat-to-cat appears to be possible.

It is important to note again that there is currently NO EVIDENCE that SARS-CoV-2 can be passed from cats to people, so there is no need for owners to do anything that would endanger the welfare of their cats (i.e. relinquish to a shelter or abandon them) even if a cat is diagnosed with COVID-19.

What do I do if I become sick with COVID-19? Who will care for my cats?

If a feline caretaker is diagnosed with COVID-19, the CDC recommends that, if possible, that person quarantine themselves from other people and animals, and that they leave the care of the cat(s) to another individual in the home. If living alone, the current recommendation is to avoid contact with the cat as much as possible, that the COVID-infected person wash their hands carefully before and after interacting with the cat or its waste, and that they refrain from allowing cats to lick or breathe in their faces.

It’s important to understand that the process of even temporarily rehoming a cat after someone in its household is diagnosed with COVID-19 may expose other cats to infection, and would likely cause stress in the rehomed cat. Since it is currently unclear how such stress may affect a cat’s ability to fight off COVID-19, and since cats may not develop significant illness even if infected, the current recommendations not to rehome a cat in this situation are very reasonable, in our view.

Could cats ever become ill enough to pose a threat to humans?

There is currently no evidence that cats can transmit SARS-CoV-2 to people, and the degree of disease that the virus causes in cats is unclear at this time. The feline infections (both natural and experimental) documented thus far appear to have resulted in relatively mild symptoms.

It is not possible to predict whether SARS-CoV-2 will ultimately be shown to be transmissible from cats to humans, but investigation into this is ongoing. It’s important to note that there are other viral respiratory diseases that cats are susceptible to that they cannot transmit to humans.

What do we know about seriousness of COVID-19 in domestic cats and ferrets? Possible transmission to humans?

Both cats and ferrets appear to be at least mildly susceptible to SARS-CoV-2 infection, but neither species appears to develop significant signs of disease when infected. There is no evidence that either species can transmit SARS-CoV-2 to humans.

Was the Malayan tiger at the Bronx zoo truly positive for COVID-19? With COVID-19 found in the tiger, what is the probability/possibility of the infection being transmitted to other cats?

The Malayan tiger at the Bronx Zoo was showing signs of mild respiratory disease (as were a few other tigers and lions at the zoo), and while ruling out other potential causes of these signs, it was decided that a SARS-CoV-2 test would be appropriate. The test identified genetic material of the SARS-CoV-2 virus in the upper airways and trachea of the affected tiger, and combined with the symptoms observed, a presumptive diagnosis of COVID-19 was made at Cornell and the University of Illinois, later confirmed at USDA’s National Veterinary Services Laboratories.

The other tigers and lions were not tested, as acquiring samples for this test requires anesthesia. Given the mild signs in these other cats and the fact that anesthesia carries some degree of risk, it was decided that the risk did not warrant obtaining samples from these other big cats, but spread of the disease amongst them could be possible. All of these tigers and lions are being monitored carefully and are doing well.

The infection documented in the Malayan tiger is significant in that it is the first documented case of animal COVID-19 in the US, and because it suggests that tigers (and perhaps other wild feline species) are susceptible to SARS-CoV-2 infection.

Learn more about the testing: Cornell testing aids in diagnosis of COVID-19 in Bronx Zoo tiger

How are cats and dogs tested, and will we be able to test them? How long are we or animals infected for?

The tests currently being used use polymerase chain reaction (PCR)-based technology. PCR allows researchers to identify very small amounts of the genetic material of the virus in samples obtained from patients.

Cats and dogs are not being routinely tested at this time, and acquiring a test for an animal requires regulatory permission. Should other animals be confirmed positive for SARS-CoV-2 in the United States, USDA will post the findings.

It is important to point out that the test used for animals is different from that used for people.

Can you share some of the similarities and differences between SARS-Cov-2 and FIP Coronavirus (FIPV) of cats?

Coronaviruses are a group of viruses that can infect mammals and birds, but it is important to understand that while FIPV and SARS-CoV-2 are both coronaviruses, they are actually quite genetically different.

Cat aficionados are most familiar with the ubiquitous feline coronavirus (FCoV), which is shed in the feces of infected cats and usually causes relatively benign, self-limiting gastrointestinal problems in infected cats. If FCoV undergoes certain mutations to the FIPV form of the virus within a given cat, though, it can lead to the very serious disease known as feline infectious peritonitis (FIP), which is life-threatening and for which we have only recently identified a potential curative therapy.

The strain of coronavirus that causes COVID-19 (SARS-CoV-2) appears to affect primarily the respiratory system of both people and the animals it infects (cats, dogs and ferrets have been shown to be susceptible thus far). While it can cause very serious disease in people, the degree of disease that it causes in animals is unclear and perhaps variable. SARS-CoV-2 appears to be transmissible primarily by droplets of respiratory secretions, although it has also been identified in the feces of at least one presumptively infected cat.

There is no evidence that SARS-CoV-2 can mutate to cause FIP.

Learn more about FIP: Dr. Gary Whittaker, The Deadly Cat Virus

Coronaviruses in cats and other companion animals: where does SARS-CoV-2/COVID-19 fit?

Coronaviruses (CoVs) are part of a complex and diverse group of viruses grouped into four different genera Alpha-, Beta-, Gamma- and Delta-, based on their evolutionary and genetic characteristics 1 . In animals, CoVs cause major disease problems in a wide range of agricultural and companion animal species. Read more on this authors: Stout, Alison E.; Andre, Nicole M.; Jaimes, Javier A.; Millet, Jean K.; Whittaker, Gary R

Can you explain the difference between zoonosis vs. viruses which can be transmitted from humans to dogs and cats?

Zoonosis refers to the situation when an animal serves as a source of infection for people. When humans serve as the source of infection for animals, this is referred to as reverse zoonosis.

The process of viruses “jumping” from animal species to humans is a major public health concern. Both influenza and SARS-CoV-2, for example, “jumped” from animal species to humans.

Learn more about zoonotic diseases from the CDC

Is anyone screening cats and dogs in households of COVID-19 positive owners?

At this time, animals are not being routinely screened for COVID-19. Animals may be tested upon veterinary request and with regulatory approval under certain circumstances. Should other animals be confirmed positive for SARS-CoV-2 in the United States, USDA will post the findings.

Should I keep my cat inside?

Cats should always be kept indoors, as those that are allowed to roam outside unsupervised are at increased risk of a variety of infectious diseases, accidents, predation and of becoming lost. They can also serve as sources of infection for other cats if they have infectious diseases such as feline leukemia and feline immunodeficiency virus. In addition, outdoor cats can have negative impacts on native species such as small mammals and birds.

Out of an abundance of caution, the CDC currently recommends that owners wash their hands before and after interacting with their cats and litter boxes (washing hands frequently is a good idea anyway), but there is currently no evidence that cats can transmit SARS-CoV-2 to people.

Smokey was one of the very first cats cured of FIP in the first UC Davis drug trial using antivirals in 2016.

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Learn more about the cats featured in this article

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