Dry FIP Recovery Journey, Day 57 (Neuro-Ocular Combined)
Skye's Healing Journey, For Those Looking for Hope
TL;DR: Our kitten was found falling off a roof in Türkiye as a stray, adopted into our family, and nearly died at 9 months old from combined neurological and ocular dry FIP. He could not stand, walk, eat, or lift his head without support. Within 48 hours of starting GS-441524, he jumped onto our bed and ate independently. 57 days later, he is running, playing, bringing toys to bed, and developing new behavioural and social skills in the best possible way. There is hope! Keep fighting for your baby.
Why We're Sharing This
It was hard to find stories about combined neurological and ocular dry FIP (severe) when we were learning about FIP, so we want to share our journey for anyone who is where we were. If this helps even one person recognize symptoms earlier, advocate harder for their cat, or simply feel less alone at 3am during a syringe feeding shift, it is worth it.
Background
Skye is an ~11-month-old tuxedo kitten who was found falling off a roof in Türkiye as a very young kitten before being adopted into our family. From the beginning, he was ravenously hungry, deeply affectionate toward humans, and a champion sleeper. His vet's impression was that he was a normal, albeit small, kitten recovering from worms and street life.
What We Missed: The "Something Off" Stage
We hope that recognizing early signs sooner might make a difference for someone else's cat. One of our biggest mistakes was seeing different vets at the same clinic, trying to catch each one up on his history, instead of working with the same person to observe his health over time.
At 4.5 months (adoption), he was small for his age at his wellness check, gaining less than the expected 1 pound per month typical of healthy kittenhood (in hindsight, early signs of a failure to thrive, exacerbated later by FIP suppression immune function and nutrient absorption, though we had attributed this issue to worms and early childhood malnutrition). Despite maintaining a healthy appetite, being provided fresh wet kitten food 3-4x daily, and free access to kitten dry food, he gained nothing for weeks. His belly was bloated and descended after eating, a sign we noted but accepted reassurance about, since he had received worm treatment two weeks before his adoption visit. Two weeks later, after finding a worm segment, we treated him again and he has been worm-free since.
At ~5-6 months, Skye had persistent eye and nasal discharge with discoloration that was attributed to a mild upper respiratory infection and then suspected feline herpes virus (FHV-1). He was given antibiotic eye drops and L-Lysine to manage symptoms, which seemed to improve at the time. Gradually, his eyes developed uneven pupil dilation and subtle cloudiness (intermittent anisocoria and corneal haze) that we noticed but were reassured about by his vet, who did not observe significant abnormalities early on. At one point I genuinely believed I was just an anxious kitten parent. I was not, and I could have consulted with an optical specialist at that stage.
At ~8-9 months, he began licking the same spot on our wooden office floor every time he entered the room (compulsive repetitive behavior, an early neurological symptom we had no framework to interpret). We cleaned the floor repeatedly thinking he smelled something or was just being a playful, adolescent kitten. Meanwhile, he continued to occasionally step in his feces or urine while using the litter box, another motor coordination symptom, which we suspected was a consequence of delayed development due to early childhood malnutrition. (We remained hypervigealant and kept wipes handy, while adding fiber to his diet with vet approval). As a clinical psych tester, I believed he had cognitive delays, as he was highly food motivated but appeared to require human direction to remember the fixed location where I provided food regularly, a symptom I believed was unusual but had no visible decline or reason to suspect an underlying cause. Hindsight can be heartbreaking.
The acute neurological collapse came on within 24-48 hours (I read that FIP cats are at higher risk of death within 72 hours of ataxia, particularly without treatment). If your cat has unexplained failure to thrive, recurring eye symptoms, subtle behavioral changes, or compulsive repetitive behaviors that don't fit a clear diagnosis, please ask your vet specifically about FIP. It is no longer a death sentence if caught and treated, and now is better than later.
As a consequence of shifting practitioners, vets relied on us to explain the current presentation and history without personal experience examining his symptoms comprehensively over time. Neither we or our vets realized that the totality of symptoms were consistent with early FIP, nor did we have the clinical experience to connect health concerns over time (e.g., eye cloudiness and hunger that we had been told was normal early on).
Diagnosis: Peak Symptom Period
Skye was diagnosed with combined neurological and ocular dry FIP after developing severe symptoms between breakfast and the end of a workday. He displayed a disoriented drunken stagger (ataxia) that rapidly declined to near complete hind leg paralysis (posterior paresis), leaving him unable to stand, walk, or use the litter box without support within 24 hours. He reacted with distress and aggression when touched, biting and growling at gentle contact (hyperesthesia, abnormal pain sensitivity from CNS inflammation).
We took him to an animal emergency hospital immediately after coming home from work to see ataxia, and testing was performed. When we called that evening to explain that his coordination and appetite had declined further, the emergency vet believed the decline was due to sedation required for testing. We waited 24 hours before learning that his results had arrived that morning, but no emergency vet had reviewed them. A new vet quickly looked them over and explained that if it was FIP, pending ultrasound and toxoplasmosis testing confirmation, there was no treatment available. Fortunately, I am a neurotic clinical researcher with training to interpret scientific articles, who had spent the previous 24 hours reading into possible differential diagnoses, and found that a new antiviral treatment was available for FIP. We remained cautiously optimistic but desperate for an answer. As regular daytime normal vet had closed for the day and the emergency vet had no ultrasound tech available, I spent that night calling and emailing local clinics to request an urgent ultrasound referral, which I was told may take days. (Note: To be fair, Skye’s emergency vet specializes in diagnosis and imminent care, so he may be less well-read on emerging long-term treatments due to the limited scope of his practice).
With no appointment guaranteed, we showed up at our regular vet at opening the next morning and asked for an ultrasound. That vet, who had treated FIP before and is nothing short of Skye's angel, agreed to see him immediately, was thankfully able to perform the ultrasound on site, consulted with a vet FIP treatment group including a world-leading expert on Skye's behalf, and rush-ordered same-day delivery of his medication before his symptoms could decline further. By the time we received his medication, approximately 50 hours after ataxia began, he could no longer lift his chest independently and had developed audible nasal breathing during deep sleep. We drove back to pick it up just before the daytime clinic closed and started treatment as soon as we got home, afraid he would not survive the night. We want to note that some vets also administer steroids alongside antivirals in the acute phase to help reduce CNS swelling and prevent spinal cord involvement, which is something we and our vet were not aware of at the time and worth asking your vet about.
Given that he had not eaten since developing ataxia, perhaps due to nausea though he did not vomit, we mixed water into his wet food, manually elevated his chest to prevent aspiration, and syringe-fed him every 2-3 hours from 6am -10pm to ensure he met his minimum caloric needs for liver function and then for kitten growth and healing. It was stressful for all of us, but we believed it was necessary to save his life. Lifting his chest and holding him + feeding him required me and my partner together, but we reached his sick kitten dietary minimum and gave him medication that day.
Treatment
GS-441524, an antiviral that works by blocking the virus's ability to copy itself inside the cat's cells (RNA-dependent RNA polymerase inhibitor), dosed by weight on a twice-daily schedule. Dose has been adjusted upward 3x as he has gained weight because the drug is dosed per kilogram. This matters because under-dosing due to weight gain can allow the virus to rebound (sub-therapeutic dosing) and increases risk of antiviral resistence). We are currently on Day 57 of an 84-day (with possible extension) protocol, with our vet requesting bloodwork between weeks 10-12 before the final assessment.
Growth
May 5 - Ataxia onset - 2.54 kg (underweight)
Day 0 - May 7 - Treatment start
Day 2 - May 9 - 2.60 kg
Day 29 - June 5 - 3.005 kg
Day 44 - June 20 - 3.160 kg
Day 57 - July 4 - 3.230-3.245 kg
+685g (1.51 lb.) gained since treatment began. Still underweight for his age but trending consistently upward, albeit with 2 minor dips along the way). We weigh 2x weekly after breakfast using a precise baby/ pet scale because accurate weight is key for maintaining the correct dose-to-weight ratio as a growing kitten (therapeutic dosing accuracy). I’ll also note that we follow his medication regiment religiously (after once adjusting 30min under vet guidance for sustainability), and we plan our schedule around his medication. We fear adjusting protocol could decrease efficacy of treatment, but again I’m neurotic and always evaluate risk, which here cannot yet exclude death.
Neurological Recovery Timeline
Day 1 (first 24 hours of Tx.): Head lifting returned; rapid decline stopped. At 24hrs, began to attempt crawling and independently walk to the door of a padded tent we confined him in for his safety (fearing concussion/head trauma/etc). We kept the top of the tent open since he could not jump, so we could supervise overnight.
Day 2 (first 48 hrs): Woke us up at 4am by JUMPING BY HIMSELF onto the bed to cuddle with us. We both sobbed and for the first time, really let ourselves accept hope that we believe he could live in our hearts. He also ate by himself via a wide, flat silicone lid and wet food with churu topper. He used the litter box independently that morning.
Day 5: First self-grooming including lifting legs to groom his bum (requiring meaningful core strength and body awareness, called proprioception), toy tracking resumed, predatory play emerging. We used play to encourage proprioception and supervised/safe movement exercises, knowing that used neurological pathways become stronger.
Day 6: Zoomies, which in hindsight were unprecedented; one of the first meaningful milestones showing motor pathways in the brain were reconnecting (cerebellar and motor cortex recovery).
Day 11: Running, jumping, catnip response developing for the first time (at 9.5 months). The catnip response requires intact smell processing, brain interpretation, and hormonal response (intact olfactory and neuroendocrine function), meaning higher-order brain processing was coming back online. Before anyone comments, he had already been neutered as soon as he reached a minimum weight for safe surgery.
Day 14: Playing with his sister for hours with equivalent or greater energy levels.
Day 26: Jumping onto kitchen counters, a new behaviour, which we were deeply grateful to have the opportunity to teach boundaries for using sticky tape on the counter as a minimally stressful, passive deterrent (which works better than active human deterrence, which are not always present). Pupil dilation became more symmetrical in response to light (Anisocoria was no longer observed), suggesting intraocular inflammation was resolving.
Day 40: Carrying his favourite balls to bed overnight, intense hunting instincts returning (predatory drive solidifying), bobblehead wobble noticeably reducing, beginning to show emerging social skills including learning to take turns during play (laying down and submissively showing his stomach after attacking) and grooming his adopted sister back regularly (prosocial behavior requiring social cognition that was entirely absent at his worst). Note: we implemented scheduled play to exhaustion, followed by a large feeding just before our own bedtime routine, followed by completely ignoring play requests (blanket over head and laying still), which has removed the incentive to wake us and has helped him allow us to sleep through the night before waking us up promptly for his breakfast and medication routine.
Day 57: Confident walking, hind leg balance, controlled and precise jumps, daily zoomies, retracting claws appropriately during play with his sister (claw inhibition, a fine motor and impulse control skill), and somehow carrying two balls to bed simultaneously.
Residual symptoms still present: maintains reduced head shakiness when excited or focused on a toy (intention tremor, consistent with incomplete cerebellar recovery), and some difficulty focusing the eyes on fast-moving targets (ocular tracking deficit). Neurological (particularly cerebral fine motor movement) and optical healing can take several months, so these symptoms are unsurprising at this stage and continuing to improve. We hope he will have the opportunity to continue healing into his post-treatment, 12-week observation phase.
Ocular Recovery (Photographed)
We have been using photos to track Skye's eye changes photographically since before diagnosis and the progression is visible. We are sharing this series because we hope others may be helpful to see clear before, during, and after ocular FIP photos when we needed them most.
At 4-5 months (healthy baseline around adoption): clear, bright, symmetrical pupils with clean olive-green iris and sharp definition. This is what his eyes looked like before FIP, and what we are working back toward.
At 9 months (diagnosis): the iris had shifted to muddy amber/orange (anterior uveitis causing inflammatory pigment changes), the iris surface appeared swollen and uneven (iris thickening from immune cell infiltration), the pupil border was less crisp, and the right eye had visible surface cloudiness (corneal haze from protein-rich fluid accumulating in the anterior chamber). Pupil sizes were noticeably unequal and more extreme in dim lighting than captured in photos (anisocoria reflecting asymmetric intraocular inflammation). We want to note that the subtle cloudiness in his right eye was something we observed and flagged before diagnosis, but were reassured about. Trust your instincts.
Months 1-2 of treatment: cloudiness and unequal pupil dilation began visibly improving. Around Day 57 (current): the eyes are noticeably cleaner, pupils are symmetrical and reactive, corneal cloudiness has resolved, and the iris surface appears smoother and less inflamed. The iris color remains amber rather than his original green, which may reflect permanent pigment change from the resolved inflammation (post-uveitic iris pigmentation), a cosmetic rather than functional change. You can also see that he is beginning to look like an adult cat.
We believe his eyes may continue improving 3-6 months after treatment onset. Whether full visual acuity has returned requires an ophthalmology exam to confirm, but behaviorally he can better track fast-moving toys, responds to visual cues across the room, and navigates with confidence.
Diet and Nutrition (Vet-Monitored)
Because neuro-ocular FIP requires higher antiviral doses (the blood-brain barrier limits how much drug reaches the brain and spinal cord, called limited CNS penetration), weight gain directly affects whether Skye is receiving a therapeutic dose. We approached nutrition as an integral part of his treatment.
Our protocol evolved over time under vet guidance. Early in treatment, the priority was calories above everything else and we used whatever he would eat, prioritizing nutrient-dense foods. Once his weight stabilized, we overhauled the entire household food setup with our vet's input, because Skye steals food from his adult sister, Stormi, with impressive and relentless greed. To manage this practically and protect his urinary health, we removed all dry food from the home entirely and switched every wet food in the house to support a healthy urinary pH (vet approved). Stormi now eats an adult Royal Canin urinary SO wet food, which helps dissolve and flush crystals by gently acidifying the urine (reducing struvite crystal formation via urinary acidification), and conveniently also happens to be what Skye raids when given the opportunity. Skye eats Royal Canin Gastrointestinal Kitten canned food, which our vet recommended as lower in crystal-promoting nutrients while still meeting his kitten growth and weight gain needs. Currently, there is no kitten food available designed for dissolving crystals, and adult food alone does not meet his caloric needs.
His liquid medication is mixed into Tiki Cat Baby Thrive sachets twice daily, a high-calorie squeeze pouch format he eats willingly and completely, though we wipe any drops and let him lick them off our fingers to make sure he consumes full dose absorption (bioavailability), since any waste means underdosing.
We stopped all supplements aside from two: salmon oil for omega-3 fatty acids supporting brain and retinal recovery (DHA and EPA), and quail egg yolk two to three times weekly for choline and B12 for nerve repair and DHA for retinal healing. We chose quail over chicken egg yolk for its lower phosphorus content and higher caloric density, which matters given his crystal history. We stopped other supplements intentionally, because many can alter urine pH and would work against the urinary crystal management we are achieving through diet (interference with targeted urinary acidification).
A note on L-Lysine specifically: Skye had been prescribed L-Lysine before diagnosis for suspected feline herpesvirus (FHV-1), which was the working explanation for his early eye symptoms. We discontinued it once FIP treatment began, for a few reasons. First, his eye symptoms were now understood to be ocular FIP rather than FHV-1, so the original rationale no longer applied. Second, the evidence base for L-Lysine in cats has become increasingly mixed: a 2015 systematic review found no evidence it inhibits FHV-1 replication in cats at normal arginine concentrations, and two clinical trials observed that L-Lysine groups had increased viral replication in some cases. Third, oral L-Lysine supplementation can deplete arginine in cats, who cannot synthesize this amino acid independently, and low arginine levels can cause serious systemic complications. There is no published evidence that L-Lysine directly interferes with GS-441524, yet to my knowledge, there is no evidence of possible impact whatsoever. Presently, the benefit-to-risk case for continuing it during active FIP treatment did not warrant continued use in my personal view, but scientifically, there is an open question here. As always, discuss any supplements with your own vet before making changes.
Tips: warming food to body temperature before serving increases palatability for picky or reduced eaters, which matters when neurological damage affects appetite signaling. Small frequent meals support better nutrient absorption and steadier blood glucose for brain healing. Rotating 2-3 appropriate food options early on prevented food aversion to Skye’s normal daily foods, a real risk in cats who are force-fed or repeatedly offered the same food during illness. And on some of the hardest days, his sister's food scattered as a topper on his own, or feeding his sister close by was all it took, as occasionally cats can survive on spite or jealousy. Lastly, early on, he did not want to try his high calorie tikki baby thrive treat, so I rubbed it onto his feet and he groomed it off. Ever since, he has loved them.
What Helped Skye
Weighing 2x weekly at the same time after feeding, to accurately track dose adjustments as he grew. A consistent twice-daily medication schedule with no missed or delayed doses. Daily physiotherapy play sessions using toys, tunnels, and his adopted sister to rebuild the brain connections needed for balance and coordination (neuroplasticity, the brain's ability to form new pathways after injury). Keeping his environment calm, his schedule consistent, and his nutrition optimized to reduce stress. We are thankful to have found a primary vet who believed in FIP treatment, consulted with food company’s nutrition specialists directly on his behalf, adjusted his dose proactively as he grew, and has been nothing short of heroic in her attentive email replies as we track healing. We are endlessly grateful.
Current Status
Day 57 of 84. Second bloodwork recheck coming up July 14-24. Pending results and clinical changes, we may end treatment on July 30, followed by a 12-week observation period with close, viral relapse monitoring.
We know neuro-ocular FIP has a lower success rate than other forms, around 43% for combined neurological and ocular involvement per a 2025 systematic review (though extremely small sample with no timeline of increased survival rates discussed in analysis), which is why we are staying vigilant and not getting complacent. We are not done yet, but now we know what to watch for.
Currently, our boy is running, jumping, eating, playing, and tormenting his adopted sister, who he first began grooming only after treatment started. He brings his favorite toys to bed. He is learning more advanced social and behavioral skills than we ever expected to see. He makes biscuits on us at midnight to ask for snacks and we let him every single time.
He was found falling off a roof as a stray kitten in Türkiye. He nearly died in our arms at 9 months old. And today he is thriving. Prolonging and hopefully saving Skye’s life has been the most meaningful accomplishment of my life so far!
Happy to answer questions about our protocol, diet, daily care routine, or anything else. Rooting for every cat and every family fighting this disease. ❤️
(Edits: clarity and grammar)