From Big Cats to Breakthroughs - Emerging Diseases & New Therapeutics

In the October episode of Chattering With International Cat Care, we spotlight progress and innovation in feline clinical medicine through two compelling conversations.

First, Sam Taylor speaks with Gabriele Ratti, winner of the ABCD Young Scientist Award, about his research into emerging infectious threats in cats. They explore the shifting landscape of feline infectious diseases, the challenges of studying both unowned and wild felids, and the critical role of prevention and biosecurity across species and settings.

Then, Kelly St. Denis is joined by William Whitehouse and Katrina Viviano to discuss their recent JFMS article on feline clinical therapeutics. Together, they unpack new developments in pain management, drug therapies for conditions like FIP, HCM, and chronic kidney disease, and what these advances mean for veterinary teams and cat caregivers. From once-untreatable diagnoses to evolving best practices, this conversation highlights how ongoing research is reshaping feline care.

For further reading material please visit:

Molecular Detection of Feline Coronavirus in Captive Non-Domestic Felids from Zoological Facilities

Further Research From Gabriele Ratti

Clinical therapeutics in feline medicine: updates for old and new drugs

View The Transcript Here

For iCatCare Veterinary Members, full recordings of each episode of the podcast are available for you to listen to at portal.icatcare.org. To become an iCatCare Veterinary Member, or find out more about our Cat Friendly schemes, visit icatcare.org

Host:

Yaiza Gómez-Mejías, LdaVet MANZCVS (Medicine of Cats), RCVS CertAP (Feline Medicine), iCatCare Veterinary Community Co-ordinator

Speakers:

Sam Taylor, BVetMed(Hons) CertSAM DipECVIM FRCV, Veterinary Specialist Consultant and Veterinary Specialist Lead at iCatCare

Gabriele Ratti, DVM, PhD, ECVM resident, Veterinary microbiologist with experience in diagnostics and research focused on infectious diseases

Kelly St. Denis, DVM, Dipl.ABVP, Co-editor of the Journal of Feline Medicine and Surgery and JFMS Open Reports and board-certified feline specialist

William Whitehouse, DVM, DACVIM (SAIM), Assistant Professor of Small Animal Internal Medicine

Katrina Viviano, DVM, PhD, DACVIM (SAIM), DACVCP, Head of Small Animal Internal Medicine 

Creators and Guests

Host

Yaiza Gomez-Mejias

Veterinary Community Co-ordinator @ International Cat Care

What is Chattering with iCatCare?

Welcome to Chattering With iCatCare, the official monthly podcast of International Cat Care, hosted by Yaiza Gomez-Mejias (Veterinary Community Co-ordinator). Each month, we chatter about cats and cat-friendly practices with industry experts and contributors to The Journal of Feline Medicine and Surgery. Each episode contains highlights from our longer discussions and interviews, which are accessible to iCatCare members at portal.icatcare.org. If you would like access to our full episodes, would like to become an iCatCare Veterinary Society Member, or find out more about our Cat-Friendly schemes, visit icatcare.org.

Hello, and welcome to
Chattering With iCatCare.

I'm Yaiza Gomez, iCatCare
Veterinary Community Coordinator

and host of this podcast.

Today our clinical spotlight
is focused on treatment tools.

Dr Kelly St Dennis will be interviewing
William Whitehouse and Katrina Viviano

on a JFMS article about updates on
feline clinical therapeutics, but

before Sam Taylor will be interviewing
Gabriele Ratti, who was awarded

the ABCD Young Scientist Award
this year for his study focused on

emerging infectious threats in cats.

Welcome Dr Ratti and
thank you for joining us.

What is it that you find so fascinating
about feline infectious diseases?

Infectious disease are interesting
because they are ever changing.

If you think about emerging
pathogen especially, we work with

microorganism that are in evolution
run, so they change a lot over time.

This is the main thing that I found
so interesting about infectious

disease apart also from the
pathogen to host interaction.

cats in this topic are really, really
strange if you think about compared to

other animals, we have a lot of virus
with strange biological characteristic

or biological behaviour, such as FIP.

cats are so interesting.

So picture, when you think about
infectious diseases and they also

have zoonotic pathogen, for example
staphylococcus aureus is more common

in cat compared to other species.

And is that to do with their lifestyle
and their varied lifestyles as well

as their physiology, is it to do with
the fact that cats live differently

in different parts of the world?

Is that part of that?

Absolutely.

If you go to the evolution of felids in
general, you will see a lot of fun stuff.

For example, lion have FIV, such as cat,
but its not a pathogen for that species.

And of course cat have a lifestyle.

I used to work with stray cats and I
try to understand by reading article and

stuff like that, how stray cat behave,
where did they roam within the territory?

They have, they, they are really
fascinating by a ecological point of

view also and yes, absolutely, these
are things to keep in mind when you

study cat in general because cats are
so different compared to other animal,

especially by ethological points
of view and this kind of ethology

every precaution on feline infectious
disease epidemiology, for example.

Okay.

It is, that is fascinating and you
brought up then your work with stray

cats, and I think you've done quite
a bit with unowned cats, haven't you?

So people who are not aware of some
of your research, obviously would

encourage them to go and read all your
papers, but you have published a number

looking at E. coli in unowned cats.

Is that correct?

Could you tell us a bit about why,
and also I'm really interested

in how do you study unowned cats?

Because they're not known for being cats
that you can catch easily or handle or.

We got fortunate about stray
cats because when I was in the

University of Lodi we have a

contract with the health care system
that work with the stray cat population

and in order to do nurturing program for
population control, we used to capture

a lot of stray cat, put that on the
generalisation to perform a sterilisation

and so we were able to collect sample for
screening of SARS-CoV-2, antimicrobial

resistance and stuff like that.

Because at that time we were in
the early stage of pandemic and

we actually, in Lodi, we had the
first  SARS-CoV-2 cases reported

in Europe, if I remember correctly.

And so we had a lot of interest,
especially in the early stage of

pandemic because there was a paper that
say that under experimental condition

cats were able to contract  SARS-CoV-2
and transmit it to other cats.

We were really curious about
the epidemiological stuff

going on, feline colonies, the

stray population in general
after that paper and so we start

to collect swab from both stray

cat and also by owned cat that were
admitted to the veterinary hospital

for general practice, basically.

And yes, we do a little bit of
comparison with the antimicrobial

resistance between the two
population in our study basically.

Before I let you go, obviously we're all
cat lovers here, but you have done some

work with lions and tigers and big cats.

I wondered if you could tell us
about your work looking at infectious

diseases in the non-domestic cat.

Actually, it was my graduation thesis,
the search for feline coronavirus

of Tiger Lion and stuff like that.

But we search also for

other pathogen in

that kind of animal, which
are really interesting also by

the infectious point of view.

And basically, once again, we don't
find nothing because when you

think about captive population, they
are really, really controlled by

not only by the diagnostic point of
view, so biosecurity and stuff like

that, but also for the breeding lion.

So you will get a lot of struggle
to find infectious diseases in this

animal, but because the, there is a
big detection to biosecurity in zoo,

which is really good in my opinion.

And there are a lot of diagnostic
going on this animal to keep this

population free from pathogen, which
is really good because if you think

about these species of feline, they
are greatly in danger basically.

So you had to work a lot on disease
prevention in this animal species rather

than cure when the disease is manifested.

So do they get FIP?

Yes.

It is really rare, I have to be honest.

But there are a lot of reports,
particularly in cheetah.

They got a lot of genetic problems,
genetic issue, and they are

susceptible of a lot of infectious
disease and particularly FIP.

Did I hear you mention
lions can get FIV as well?

Yes.

Yes, but it's not pathogenic?

Pathogen in lion, they, they used to
search for viral lymphocy depletion,

but at the end of the day, they use the
integration of FIV to track the breeding

in Africa between lion from different
group because you search for the viral

transmission light to understand the
behaviour of this animal, but in general,

big cat are quite strange in infectious
disease epidemiology because they are

like dog and like cat in the meaning
that they can get this type of virus.

This is pathology typical of dog.

They get FIV, but it's not pathogen.

They, for example, lynx have

FLD.

But it is really amazing because you think
about lion, tiger and stuff like that as

big cat but, but the infectious disease
point of view, they are not, they're more

or less a bridge between dog and cat.

So they are so interesting.

Oh, that's fascinating.

Now, Dr Kelly St Dennis will be
interviewing Katrina Viviano and

William Whitehouse on their recent
JFMS article titled 'Clinical

Therapeutics in Feline and Medicine,
Updates for Old and New Drugs.'

One of the things I found very exciting
in my career is that the advancement

of analgesics in cats and our ability
to detect pain in cats with different

things like feline grimace scale.

So you covered 12 different
drugs or drug classes.

Some of them are analgesics,
anxiolytics, diabetes medications

and treatments for FIP and HCM.

How did you end up narrowing
it down to these 12?

It was a pretty collaborative effort
between kind of Dr Viviano and

myself, I guess it was, oh, a little
over a year ago, and I did a locum

at the University of Wisconsin.

We were talking about one of the drugs
we covered, but we had previously done

a review article about a decade ago
now on kind of new therapeutics in

feline medicine at that point in time
and just with the influx of new agents

that are coming onto the market, getting
approved for cats, as well as learning

about kind of new uses for old drugs.

We thought it would be a great
time to revisit this and explore

and summarise again what is out
there for feline practitioners.

We started off with, I guess, just looking
at what is new and then trying to think

about what important papers have come
about for more traditional drugs, and

there are probably those out there that we
just weren't aware of or didn't include,

but these are the 12 we ended up with.

I think it's an amazing list.

Some diseases that were previously not
treatable, HCM and FIP probably being

the most notable based on the, the
drugs that you have in this article,

like what are your thoughts on drugs
that are changing the way we do things?

I remember early in my career like
having to help so many families

say goodbye to their cat, like
after diagnosing them with FIP.

It's remarkable that we have a
treatment that works quite well.

It's wonderful to see the complete
180 and prognosis for these patients

happening during our lifetime.

Mm-hmm.

I think for HCM is a similar thing.

We're starting to see
exciting advancements.

As someone who practices in
Northern Ontario, we don't have

access to a lot of referral.

We don't have echocardiogram here.

So when we diagnose heart disease
in a cat, we don't always, in the

past, have gone for any diagnostics
because there wasn't a lot for us to

do if they did receive a diagnosis.

But now things that, again, that has
changed where we can say to people,

look, if we can get the diagnosis, then
there's probably some things we can do.

And I wondered if you wanted to touch
on the new drugs available for HCM?

Yeah.

So that I would say with regards to
rapamycin, I think is still something

that is, is truly up and coming
and we're still learning about.

So the initial studies look very
promising with regards to what it does for

progression of ventricular hypertrophy.

I do know a lot of cardiologists
who are really excited to see

the results of the HCM study.

There really is a lack of evidence
for kind of benefit of other

therapeutics for that disease.

I haven't treated a lot of HCM, but I
have treated a lot of kind of chronic

kidney disease in cats, and we all know
that there's a lot of negative prognostic

indicators regarding disease progression.

Of all the things we do only a small
handful of things show improved outcomes.

It would be great to have another
agent in our arsenal to help them.

I think as you kind of alluded
to, its use is most optimal in

association with subclinical HCM.

Reaching out to get that diagnosis
earlier to intervene is probably gonna

change how we approach these cats.

I think it's something that's
gonna evolve with time.

Yeah, and I think it's gonna be even
just understanding when a cat has heart

disease is such a challenge with murmurs
and no murmurs, a percentage of diseased

cats walking into my office every day,
and I don't know if they could have HCM.

So that even and of itself is trying
to get those cats identified as a

potential issue so that we can send
them for diagnostics is something

I'm looking forward to learning more
about as we see research unfold.

Dr Whitehouse, since you are
focusing on kidney, did you wanna

talk about the agent that helps
with feline chronic kidney disease?

Traditionally, Darbepoetin has been used
as an erythrocyte stimulating agent to

treat anaemia associated with CKD in cats.

It does seem to be effective.

It does have some side effects as well.

One of the biggest limiting factors,
especially for the cases that kind of,

I've Personally seen is the cost kind
of associated with that medication.

It can be cost prohibitive
for a lot of clients.

So it's great to have another option,
an oral option in a liquid, which we

know for the majority of cats, usually
it's a little bit easier to administer

than tablet or pill form, but it's also
shown to be beneficial for treating

anaemia, which we again know is a negative
prognostic indicator and is something

that does contribute to a decreased
quality of life with them as well too.

So there's no kind of head to head right
now showing which one is better but

having varenzin, which is molidustat,
does offer an alternative option for these

patients and is comparably less expensive.

I know we have so many drugs to talk
about and not enough time, but I wanted

to just look at analgesics in general.

But Frunevetmab was one of the things
I wanted to talk to you about today

because it's been around for a while.

Everyone's generally very happy
with its outcome and how it helps

quality of life for patients
with degenerative joint disease.

As with everything we start to see
cautionary tales, rightly or wrongly.

I wanted to talk about your feelings
about the drug safety profile.

If we do see some concerns,
what are those concerns?

It's one of those drugs that
really addresses a need.

A lot more cats have osteoarthritis
than we clinically appreciate and this

giving us an alternative option to NSAIDs
makes it exciting because most of the

cats that, not all of them, but a large
majority of them are gonna be older

cats and they have comorbidities, and
I think that's where the challenge is.

When they look at a drug and working
on approval, they're looking not only

at safety and toxicity, but they're
also looking at a specific clinical

population that otherwise are healthy
cats that just have osteoarthritis and

then it gets put out into the public
in terms of use, once it's approved,

there's probably a lot of diversity in
the patient population that gets treated.

What you're alluding to is the discussion
that's come up with librela in dogs.

That's one of the post-approval reporting
information that's out there, which is

super important for any drug because
now we're using it in a lot,broader

population of dogs or cats and then
we may see things that didn't show

up initially on the approval study.

So I think they're all warranted and
important to report and investigate.

The challenging thing is we're using
a monoclonal antibody against nerve

growth factor, and we have to remember
the target is thought to be that nerve

growth factor is increased in joints of
patients with osteoarthritis, and that's

our target, is the inflammatory piece
or the inflammatory role that's sort of

negative associated with osteoarthritis.

But nerve growth faster also has other
roles in terms of neuroprotection.

It's neurotrophic.

Can we potentially see adverse effects
that we didn't actually predict?

And that's always
possible with a new drug.

So I think it's an exciting area
and it offers another way to

treat osteoarthritis in cats.

Anecdotally, the cats I've known that
have had it, it helps quite a bit.

And so I think it's just like any
other drug or even a drug that's known,

is having your clinical criteria of
what is effective and what isn't.

And then also close monitoring, especially
when you're starting to use it in an

individual patient, knowing that a
lot of our cats with osteoarthritis

are gonna have comorbidities, probably
on other therapies, and so is there

also the risk that we may see more
adverse effects than we anticipate?

And that's always possible.

I would say know your patient
population, baseline kidney function,

but like their level of pain, their
level of activity, so you can make

objective assessments as is it working?

And always balancing that risk
benefit ratio for any drug.

It's exciting in that it's another way.

Maybe it's gonna end up being an
adjuvant therapy in some cats.

It's yet to be determined
as we use it more.

Thank you for listening.

If you’re an iCatCare Veterinary Society
Member,  don't forget that you can access

all member benefits, including the full
version of this podcast episode and

other recordings at portal.icatcare.org.

If you're looking for more free CPD
from International Cat Care, we have

several open access webinars coming.

On the 3rd of November, Cat Henstridge
and Dr Cecilia Villaverde will discuss

misconceptions in feline nutrition.

On the 12th, Gonzalo da Graca will share
some tips on how to make veterinary

visits less stressful for cats.

We'll be back again next month with more
from the world of feline medicine and

the journal of feline
medicine and surgery.