The blood test results are back. Your fur baby has been on treatment for three weeks. They are eating again — properly eating, not just sniffing and walking away. They are back to sitting in their favourite spot near the window. Every sign you can see with your own eyes tells you something is getting better.
Then you open the lab report. And the numbers look like a disaster.
Globulin: still very high. ALT: gone up since the last test. Lymphocytes: flagged. You screenshot the results and send them to your vet, to the BasmiFIP WhatsApp support line, and to three different FIP Facebook groups — all within the same ten minutes.
Here is what you need to know right now: most of those numbers are not telling you your cat is getting worse. They are telling you exactly what happens inside the body of a cat responding normally to GS-441524 therapy. Blood test results during active Feline Infectious Peritonitis (FIP) treatment are frequently alarming to read — and frequently misread, even by veterinarians in Malaysia who have limited FIP case experience.
This guide breaks down every major blood parameter, explains what it does during treatment, and tells you clearly when a value is expected versus when it actually needs urgent attention.
Why Blood Tests Are the Most Important Tool You Have Right Now
Feline Infectious Peritonitis (FIP) is caused by a dangerous mutation of the feline coronavirus — a virus many cats carry without ever becoming seriously ill. When that mutation happens, the result is a disease that attacks multiple organ systems at once, triggering sustained and severe inflammation throughout the body.
GS-441524 blocks the virus from replicating inside infected cells. But suppressing a virus that has been active for days or weeks does not mean the body heals overnight. The inflammation, the protein imbalances, the immune system changes — all of these take time to reverse. Blood tests let you track that reversal objectively, at points when what you observe externally may not yet match what is happening internally.
In Malaysia, where access to specialist veterinary experience in FIP can vary significantly between clinics — particularly outside the Klang Valley — regular blood panels become even more critical as a monitoring tool. They are often the clearest window your vet has into whether the treatment is actually working.
Blood work during FIP treatment does three things:
- Confirms the disease is actually retreating — inflammatory markers falling, protein fractions rebalancing
- Flags early side effects — particularly on the liver and kidneys, before any external symptoms appear
- Guides dosing decisions — if the response is slower than expected, the panel gives the treatment team the information needed to adjust
The standard monitoring schedule used by BasmiFIP follows the same protocol validated in clinical research: a baseline panel before treatment begins, repeat panels at weeks 4 and 8 of the 84-day course, and a final panel at day 84. After treatment ends, the 12-week post-treatment observation period requires additional blood checks at weeks 4, 8, and 12.
No single result tells the whole story. What matters is the direction each value moves across multiple draws over time.
The Key Blood Parameters Explained
Globulin
What it is: Globulins are immune proteins produced in response to infection. In cats with active Feline Infectious Peritonitis (FIP), globulin levels are almost always dramatically elevated — often between 50 and 90 g/L — because the immune system has been fighting a sustained systemic battle.
What to expect during treatment: Globulins are consistently the last parameter to normalize. It is completely normal for them to remain elevated at the week-4 and week-8 checks, even when your cat is visibly improving across every clinical sign that matters. Do not judge treatment progress by the globulin number alone. Judge it by which direction that number is heading.
What to watch for: Globulins that keep rising after week 8 — while the cat is also showing clinical signs of deterioration — may indicate the current dose is not achieving adequate viral suppression. This is the conversation to have with your BasmiFIP treatment advisor or vet, not a reason to stop treatment on your own.
Albumin-to-Globulin Ratio (A:G Ratio)
What it is: The A:G ratio compares albumin — a structural protein made by the liver — to total globulins. In healthy cats, this sits above 0.8. In cats with active Feline Infectious Peritonitis (FIP), it typically falls below 0.5, sometimes as low as 0.3 or lower.
What to expect during treatment: A rising A:G ratio is one of the earliest and most reliable indicators that GS-441524 is working. As globulins begin to fall and albumin begins to recover, this ratio climbs back toward the normal range. Seeing improvement in the A:G ratio at the week-4 draw — even when individual values are still outside normal limits — is one of the clearest positive signals available.
How to read it alongside individual values: A cat whose globulins dropped from 70 g/L to 53 g/L while albumin climbed from 14 g/L to 20 g/L is responding well to treatment — even though neither number is in the healthy reference range yet. The A:G ratio captures that progress. Individual values alone can mislead; the ratio puts them in context.
BasmiFIP's own 2024 field evaluation of 46 cats showed a consistent pattern of A:G ratio improvement in the weeks preceding full clinical remission — one of the key findings from our published study data.
ALT (Alanine Aminotransferase)
What it is: ALT is a liver enzyme that rises when hepatic cells are stressed or damaged. Elevated ALT in FIP cats can come from the disease itself, or from GS-441524 — which is documented as a cause of moderate, generally temporary ALT elevation in a portion of treated cats.
What to expect during treatment: A moderate ALT rise in the first four to eight weeks of GS-441524 therapy is a well-documented finding. It is not a sign of liver failure. It is not a sign the treatment should stop.
When to act: An ALT that climbs to more than three to five times the upper limit of the reference range, or one that keeps rising after week 8, deserves a closer look. If your cat also develops jaundice — yellow colouring of the gums, the whites of the eyes, or the skin inside the ears — this is a more urgent finding that requires same-day veterinary assessment or immediate contact with the BasmiFIP support team.
Never stop treatment based on ALT alone without speaking to a treatment professional first. Stopping GS-441524 prematurely dramatically increases relapse risk — in the vast majority of cases, that risk is far greater than the risk posed by a moderate, monitored enzyme elevation.
ALP (Alkaline Phosphatase)
What it is: ALP is another liver-associated enzyme, frequently elevated alongside ALT during Feline Infectious Peritonitis (FIP) treatment.
What to expect: Mildly elevated ALP during the treatment course is common and typically resolves on its own during or after treatment. Persistently elevated ALP after the cat has been confirmed in remission warrants specific follow-up with a veterinarian.
AGP (Alpha-1-Acid Glycoprotein)
What it is: AGP is an acute-phase inflammatory protein that rises sharply in response to the systemic inflammation caused by active Feline Infectious Peritonitis (FIP). It is measured more commonly in Malaysia and Southeast Asia than in some Western markets, and it is a useful early diagnostic marker.
What to expect during treatment: AGP typically begins falling earlier than globulin in cats responding well to GS-441524. A declining AGP trend in the first few weeks of treatment is an encouraging early signal of viral suppression. For a detailed explanation of AGP specifically in the diagnostic context, see the BasmiFIP blood test guide for FIP cats.
SDMA and Creatinine (Kidney Function)
What they are: SDMA (symmetric dimethylarginine) and creatinine measure how well the kidneys are filtering waste from the blood. SDMA is a more sensitive early indicator — it can detect reduced kidney function before creatinine rises.
What to expect during treatment: Some cats show transient SDMA elevations during GS-441524 therapy. This does not automatically mean kidney damage — GS-441524 is eliminated through the kidneys, and certain functional shifts can occur without causing lasting harm.
When to act: Rising SDMA combined with elevated creatinine, dilute urine, or noticeably increased water consumption requires veterinary evaluation. Cats who entered treatment with pre-existing kidney disease need more frequent renal monitoring across the full 84 days.
Complete Blood Count (CBC): White Cells and Differential
What it is: The total white blood cell count and the breakdown of individual cell populations — neutrophils, lymphocytes, eosinophils, monocytes.
What to expect during treatment:
- Lymphocytosis (elevated lymphocytes) has been reported during GS-441524 treatment and is not clinically significant when seen in isolation
- Eosinophilia (elevated eosinophils) is documented as a transient finding and does not by itself indicate parasites or allergic disease, unless accompanied by other signs
- Neutrophilia (elevated neutrophils) early in treatment reflects the active systemic inflammation from Feline Infectious Peritonitis (FIP) itself — this should gradually fall as treatment takes effect
A CBC trending toward the reference range between weeks 4 and 8 is a reassuring sign. Persistent or worsening neutrophilia — particularly if the cat is also developing a fever or going off food — may point to a secondary bacterial infection or insufficient viral control.
Hematocrit (PCV) and Red Blood Cells
What it is: The proportion of red blood cells in circulation. Many cats are anaemic at the time of FIP diagnosis due to immune-mediated destruction of red blood cells and suppression of the bone marrow.
What to expect: Anaemia improves progressively as viral load decreases and the immune response stabilises. Normalisation in the first two to four weeks is not realistic. Cats still severely anaemic at week 8 may need a supportive care conversation with the treating veterinarian.
Total Protein and Fibrinogen
What they are: Total protein is albumin plus globulins. Fibrinogen is an acute-phase protein that spikes significantly with active systemic inflammation.
What to expect: Total protein normalises as albumin climbs and globulins fall. Very high baseline values — above 90–100 g/L — are consistent with active Feline Infectious Peritonitis (FIP). A sustained downward trend across the 84-day course is the indicator that matters.
Reading the Blood Work Week by Week
Before Treatment Starts (Baseline Panel)
This panel documents the severity of the disease at the starting point. Expect elevated globulins, depressed albumin, a low A:G ratio, possible anaemia, and disrupted inflammatory markers. Every subsequent result gets measured against this baseline — not against the healthy reference range for a normal cat.
Week 4 (Day 28)
Cats responding to treatment typically show at this draw:
- A:G ratio improving, even if absolute values remain outside reference limits
- Globulins lower than baseline, even if still substantially elevated
- CBC moving toward normal
- Partial improvement in anaemia
- ALT possibly elevated but stable, not climbing
If globulins have not moved and clinical signs have not improved, contact the BasmiFIP treatment team via WhatsApp to verify the current dose is appropriate for your cat's actual body weight. You can also use the dosage guide on the BasmiFIP FAQ page to cross-check the dosage before drawing conclusions about treatment failure.
Week 8 (Day 56)
A well-responding cat at week 8 should show values clearly approaching the reference range. Globulins should be measurably lower than at week 4. ALT and ALP, if elevated, should be stable or declining. Albumin should show a clear recovery trend. According to the GS-441524 treatment timeline guide, this is also the phase where most cats in Malaysia begin showing sustained behavioural and weight improvements alongside the improving bloodwork.
Day 84 (End of Treatment)
The goal at day 84 is clinical remission supported by a clear laboratory trend toward normal — not necessarily perfect lab results across every parameter. Globulins in particular may still be slightly elevated. The criteria for ending treatment are:
- Clinical remission: normal appetite, stable or increasing weight, normal activity level, normal body temperature
- A:G ratio at or approaching the reference range
- No active effusions
- No other markers of ongoing active disease
Post-Treatment Observation: Weeks 4, 8, and 12 After Day 84
The 12-week observation period is not optional — it is a structured phase with its own blood work requirements. At each of the three draws, values should continue normalising. Any parameter that deteriorates after treatment ends — particularly globulins rising again, or albumin falling — must be reported to BasmiFIP or your veterinarian immediately. This pattern can indicate relapse, and early action makes a meaningful difference in outcomes.
Common Misreads — and What the Numbers Actually Mean
"ALT has gone up. I need to stop the medication." In most cases, no. Moderate ALT elevation during GS-441524 therapy is expected and generally reversible. Stopping treatment prematurely is one of the most preventable causes of relapse in FIP cases across Malaysia. Do not make this decision without speaking to the BasmiFIP team or your vet.
"Everything looks almost normal at week 4. Can we stop early?" No. Normalised lab values do not mean the virus has been cleared. The 84-day protocol exists because feline coronavirus can persist inside macrophages — immune cells — even when blood markers improve. Stopping early is the most common reason cats relapse unnecessarily.
"The results haven't improved at week 4. The treatment isn't working." Clinical improvement — appetite returning, fever resolving, energy increasing — almost always precedes laboratory normalisation by two to four weeks. If your fur baby looks and acts better but the blood work is lagging, the treatment is very likely working. Evaluate both together before drawing conclusions.
"Globulins are still high at week 8. That must mean something is wrong." Globulins are the last parameter to normalise in virtually every successfully treated FIP case. Many cats still show elevated globulins at week 8 while on a clear path to full remission. A consistent downward trend — even a slow one — is the signal you are looking for.
FAQ: FIP Blood Tests During Treatment in Malaysia
What blood tests are needed to monitor FIP treatment in Malaysia?
A complete chemistry panel — total protein, albumin, globulins, ALT, ALP, AGP (where available), creatinine, SDMA — plus a full blood count (CBC) with differential. The A:G ratio is calculated from albumin and globulins. Recommended minimum testing points: baseline before starting, week 4, week 8, and day 84 at end of treatment. Most veterinary clinics in Malaysia can run this panel in-house or via a referral laboratory within 24 hours.
What do high globulins mean in a cat with FIP during treatment?
Elevated globulins during Feline Infectious Peritonitis (FIP) treatment reflect sustained immune system activation caused by the feline coronavirus infection. This is expected during the early and middle phases of GS-441524 treatment. A consistently declining trend — even when absolute values remain above the reference range — is a positive indicator of treatment response.
Is it normal for ALT to rise during GS-441524 treatment?
Yes. Moderate ALT elevation is a documented and generally transient side effect of GS-441524 therapy. It does not automatically indicate liver damage or treatment failure. Regular monitoring is essential, and any marked or progressive rise should be discussed with BasmiFIP or your vet before any treatment changes are made.
What is the A:G ratio and why does it matter for FIP treatment?
The albumin-to-globulin ratio (A:G ratio) compares two protein fractions in the blood. In healthy cats it typically sits above 0.8. In cats with active Feline Infectious Peritonitis (FIP) it often falls below 0.5. A rising A:G ratio during treatment is one of the earliest and most reliable signs that GS-441524 is working. BasmiFIP tracks A:G ratio progress as a primary remission indicator throughout the 84-day course.
How often should blood tests be done during the 84-day FIP treatment?
Minimum recommended schedule: baseline before starting, week 4, week 8, and day 84 at end of treatment. After treatment, blood checks at weeks 4, 8, and 12 of the observation period confirm sustained remission.
Can blood work look normal even if my cat relapses?
Yes. Lab values can normalise before the virus is fully eliminated. This is a core reason why the complete 84-day treatment course and the full 12-week observation period are both necessary — regardless of how good the blood work looks at any given point.
My cat's blood results are getting worse at week 4. What should I do?
Contact BasmiFIP Malaysia immediately via WhatsApp (+60 11-5627 4308) with the full panel results. Deteriorating values at week 4 may indicate subtherapeutic dosing for the current body weight, a product quality issue, or a form of FIP requiring a higher-dose protocol. Do not change the dose or stop treatment on your own.
What is AGP and is it tested in Malaysia?
Alpha-1-acid glycoprotein (AGP) is an acute-phase inflammatory protein used as a diagnostic and monitoring marker for Feline Infectious Peritonitis (FIP). It is measured at more veterinary clinics in Malaysia and Southeast Asia than in some other markets. AGP typically begins declining earlier than globulin in cats responding to treatment, making it a useful early indicator of response to GS-441524.
Where can I get blood tests done for my cat in Malaysia?
Most veterinary clinics in the Klang Valley, Penang, Johor Bahru, Kuching, and Kota Kinabalu can run a full FIP monitoring blood panel. If your local clinic is unsure which tests to request for FIP monitoring, BasmiFIP's support team can provide a specific test list to share with your vet. Contact us via WhatsApp or through the BasmiFIP community page.
Tracking Every Result — and What to Do With Them
Keep every single blood panel. Photograph the lab report the day it arrives. Build a simple tracking table — even in your phone notes — with the date and the key values: globulins, albumin, A:G ratio, ALT, AGP if measured, hematocrit. What you are building is a trend line, and trend lines are what tell the real story.
When you share results with the BasmiFIP team, send the complete panel — not just the values that concern you. Context is everything in interpreting FIP lab work, and the team needs the full picture to give accurate guidance.
Malaysia's FIP cat owner community is one of the most active in Southeast Asia — and one of the most informed. The BasmiFIP WhatsApp community and Facebook group exist precisely for moments like this, when a result comes back and you are not sure what it means at 11 pm. You do not have to interpret these numbers alone.
If warning signs reappear after treatment ends — returning fever, reduced appetite, weight loss, abdominal swelling, or any neurological or eye changes — do not wait for the next scheduled appointment. Contact BasmiFIP immediately. Our relapse support programme is designed for exactly this situation and gets your cat back into the correct treatment protocol as quickly as possible.
For any questions about a blood result during treatment, click the Live Chat button at the bottom right of the page. We are here throughout the entire 84-day journey — and beyond.
