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Lowering his pred dose

post #1 of 27
Thread Starter 
I just talked to Jordan's vet and he said I could try to lower his pred dose to 5 mg every other day. He has been on 5 mg every day for over a year now. He is doing really well, so I'm ready to try and drop his dose. I'm nervous, but excited about getting his dose down. The vet said he will probably always be on pred due to his idopathic hypercalcimia. I know that means I will probably lose him at an early age, but I'm thrilled that he is doing well. It is definatly a case of quality over quantity. Wish him luck on his lower dose.
post #2 of 27
I hope it goes well with the lower dose.
post #3 of 27
Dumb?? alert

the lower dose is being worked out with the vet??

Good luck , I just got a long termer off
post #4 of 27
Thread Starter 
Quote:
Originally Posted by sharky View Post
Dumb?? alert

the lower dose is being worked out with the vet??

Good luck , I just got a long termer off
Yes. 2 months ago when I talked to the vet about it he really did not want me to lower it so I waited a couple months & talked to him today. He said to try & then we can recheck his blood calcium level in 2 weeks. Although, I know I will know how he is doing by his behavior. Jordan will eat any food I give hime when he is feeling fine. When his blood calcium spikes he stops eating. I hate to risk his blood calcium spiking again, but I also hate to over medicate him if not needed. It's been a year since I tried to lower his dose. If it doesn't work this time I will have to be resolved to keeping him on the higher dosage. The big differnce between now & a year ago is that he is no longer getting lactulose. I know that the jury is out on lactulose & blood calcium, but in his case I'm really praying that was the cause.
post #5 of 27
I went through all this with Wellington and Prednisone for his asthma. He started on one 5mg tablet a day and it is now, three years later, down to one quarter every other day, except in early winter when he starts wheezing and I up it to a quarter every day. It is scary to lower the dose, but it is worth trying and seeing what happens. The only thing is that pred does not stay in the body very long, so maybe discuss with your vet giving him half every day instead of one every other day, at least to start with.
post #6 of 27
Thread Starter 
I had suggested this a year ago the last time we went to every other day, but he said that was not standard. That it was standard to go to everyother day 1st? It always made more sense to me to do 1/2 every day. I just thought, well I'm not a vet what do I know.
post #7 of 27
Quote:
Originally Posted by Rang_27 View Post
...I just thought, well I'm not a vet what do I know.
Rang_27- what do we call the Vets who graduated "last in their class"?
post #8 of 27
Quote:
Originally Posted by BLAISE View Post
Rang_27- what do we call the Vets who graduated "last in their class"?
lol... sorry not for me but vet??

my vet gave me this... 5 mg then, 2.5 for the same amount of time, then 1.25 , every other day , then every third day.. YMMV
post #9 of 27
Quote:
...VMMV
HUH?
post #10 of 27
Sending that Jordan can adjust well to the lower dose.

My Stumpy has been on 5mg every other day for about 2 years now. My Muddy just went down to 5mg every other day a few weeks back and the jury is still out if I have to boost him back up. It's dicey.

I know exactly what you are going thru!
post #11 of 27
I'm very interested in this topic because my Lucas is taking Prednisone too for Feline Lupus. he has an appointment with the vet on Monday Dec 8 to change his dose. He was on 5mg for 5 days, then 5mg every 48 hourse and now I'm not sure what changed he will make. he told me Lucas will have to stay on Pred for some time.
post #12 of 27
Thread Starter 
Quote:
Originally Posted by Momofmany View Post
Sending that Jordan can adjust well to the lower dose.

My Stumpy has been on 5mg every other day for about 2 years now. My Muddy just went down to 5mg every other day a few weeks back and the jury is still out if I have to boost him back up. It's dicey.

I know exactly what you are going thru!
I can't believe how many cats here are on Pred! Why are your kitties on pred?


Quote:
Originally Posted by Momto4kitties View Post
I'm very interested in this topic because my Lucas is taking Prednisone too for Feline Lupus. he has an appointment with the vet on Monday Dec 8 to change his dose. He was on 5mg for 5 days, then 5mg every 48 hourse and now I'm not sure what changed he will make. he told me Lucas will have to stay on Pred for some time.
I've never heard of Feline Lupus. What are the symptoms?
post #13 of 27
Thread Starter 
Not that you guys want the day by day update, but this is the only place I figure I can give regular updates that people won't want to kill me. So Wednesday was the first night I didn't give him the pred, then I gave it to him last night. I noticed he ate slowly, but he still ate almost 6 oz of food. Then this morning he ate his dry food like a champ. That is a good sign so far because when his blood calcium spikes his appitite goes way down. So I have two weeks before I have a blood test done. I'm really hoping this will work. If not that means 5 mg of pred every day for the rest of his life.
post #14 of 27
Quote:
Originally Posted by Rang_27 View Post
I can't believe how many cats here are on Pred! Why are your kitties on pred?
Stumpy has an auto-immune disease called lymphocytic, plasmacytic stomititus. Basically, his system thinks that his teeth are foreign bodies and it attacked them. His teeth have all been removed, but unless you continue to control inflamation, it will get into his gums and/or throat. Since there are no more foreign bodies to remove, if it grows into other areas of his mouth, there is no real treatment and he would be such severe pain that I would have to euthanize him.

Muddy has an auto-immune disease that has attacked his bladder. It's permanently inflamed, which causes crystals, which causes blockages. The theory about keeping him on anti-inflamatories is that if we can control his bladder, it lessons the crystals, and therefore he won't block. Even if we had surgery on him to enlarge his urinary tract (to allow the crystals to pass), he still needs to remain on an anti-inflamatory the rest of his life.

Yes, I expect the pred to shorten both of their lives from a normal lifespan standpoint, but in the case of both of them, they would die quickly without it. It will improve the quality of both of their lives in the mean time. I'll take the risk to keep them comfortable.

And for anyone who uses pred, the vet should always tell you to start with a high dose, then slowly wean them down over about a 1-2 week period. Don't question your vet on it, simply follow their instructions, and don't listen to anyone other than a vet about how to dose your cat with pred. They do things for a specific purpose.
post #15 of 27
Quote:
Originally Posted by Rang_27 View Post
If not that means 5 mg of pred every day for the rest of his life.
I know that is a scary thought, but think of the alternative.

Sending vibes your way.
post #16 of 27
Thread Starter 
Quote:
Originally Posted by Momofmany View Post
I know that is a scary thought, but think of the alternative.

Sending vibes your way.

Thank you. When this first started the vet was very concerned about what the elevated calcium would do to his body. I forget what it is called but the type of blood calcium that does the most damage was very elevated. So the choice was pred with possible long term side effects or a painful death in probably less than a year. Apparently elevated blood calcim eventually calcifies all soft tissues in the body, including muscles, like the heart, and other tissue like the lungs. It's been over a year and not only is he still with me, he's been back to his usual sassy, funny, self. If I didn't think that the blood calcium had something to do with the lactulose I wouldn't even try lowering his doseage.
post #17 of 27
Quote:
Originally Posted by Rang_27 View Post
Thank you. When this first started the vet was very concerned about what the elevated calcium would do to his body. I forget what it is called but the type of blood calcium that does the most damage was very elevated. So the choice was pred with possible long term side effects or a painful death in probably less than a year. Apparently elevated blood calcim eventually calcifies all soft tissues in the body, including muscles, like the heart, and other tissue like the lungs. It's been over a year and not only is he still with me, he's been back to his usual sassy, funny, self. If I didn't think that the blood calcium had something to do with the lactulose I wouldn't even try lowering his doseage.
Jordan's disease sounds terrible!

I just noticed that your Jordan and my Muddy are the same age. It's a lot scarier when they are put on long term pred when they are so young. At least Stumpy was 11 when he started (and still going strong after 2 years).
post #18 of 27
Thread Starter 
Quote:
Originally Posted by Momofmany View Post
Jordan's disease sounds terrible!

I just noticed that your Jordan and my Muddy are the same age. It's a lot scarier when they are put on long term pred when they are so young. At least Stumpy was 11 when he started (and still going strong after 2 years).
2 years that's good to hear. Idopathic Hypercalcimia is bad mainly from the fact that they can't find a good reason for the blood calcium to be so elevated. The only choice is to treat the symptoms instead of cure the disease. I think that it is not a super common problem, but the number of cats affected seems to be on the rise. There are 5 vets in the practice I take Jordan to, and not one of them had ever treated a cat for idopathic hypercalcimia. So the vets thought he had lymphoma, but when I talked to the vet last week he said that at this point he really doesn't think it is because he believes Jordan would be gone by now. It's been difficult, but I'm thrilled at the improvments I've seen in him over the last 5-6 months. I've got my sassy boy completely back. He is even back to jumping from the floor up into my arms at least once a day.

Jordan is still doing fantastic on every other day. I think the last time we tried to go to every other day his blood calcium spiked with in about 48 - 72 hours. So far he is past the bad point last time.
post #19 of 27
Thread Starter 
Keep those vibes comming. After a week on pred every other day, he is still doing very well. Last night he ate so fast I couldn't believe it! I think his tummy is feeling better not being on the pred every day. When he was his tummy would make these burbling noises every time he ate. Now nothing. He is still eating his dry food every morning. That's the true key that his blood calcium isn't going up, when it was high he wouldn't touch dry food. I'm very excited, I would love to get him off the pred completely, but I'm happy just to have him down to every other day.
post #20 of 27
That is great news! Here's hoping he continues to do well.
post #21 of 27
Sending continued vibes for Jordan!

And idiopathic means "of unknown origin". Both Muddy and Stumpy's diseases are idiopathic. I hate those diagnoses!
post #22 of 27
Thread Starter 
Quote:
Originally Posted by Momofmany View Post
Sending continued vibes for Jordan!

And idiopathic means "of unknown origin". Both Muddy and Stumpy's diseases are idiopathic. I hate those diagnoses!
I hate that diagnosis too. I think the vets hate admiting that they don't understand something because they sure were convinced he had lymphoma.
post #23 of 27
Wow, cats are on such high doses of pred! I'm a 120lb human and I only take 7mg, and that is high for a maintenance dose. I have Addison's Disease, which is autoimmune in my case. My adrenal glands don't produce Cortisol, so I need to replace it with either pred or hydrocortisone.

Can cats get Addison's Disease from being on pred for too long and then stopping it? It happens to people, could it happen to cats? I know dogs get Addison's disease.
post #24 of 27
Thread Starter 
Quote:
Originally Posted by kara_leigh View Post
Wow, cats are on such high doses of pred! I'm a 120lb human and I only take 7mg, and that is high for a maintenance dose. I have Addison's Disease, which is autoimmune in my case. My adrenal glands don't produce Cortisol, so I need to replace it with either pred or hydrocortisone.

Can cats get Addison's Disease from being on pred for too long and then stopping it? It happens to people, could it happen to cats? I know dogs get Addison's disease.
I've actually always wondered what normal pred dosage was for a human. I am not positive about addision's, but I thought I remember my vet saying that there has never been a cat diagnosed with addisons?? I do know that just like people pred can not be stopped suddenly or it causes problems. That's why I'm working with the vet to slowly get his doseage down.
post #25 of 27
My vet keeps assuring me (I worry a lot), that pred is far easier on cats than it is on either dogs and humans. The risk you read most about is diabetes, which according to my vet, is usually self healing after a few months in cats.

I just keep reminding myself that the alternative (no pred) is worse.
post #26 of 27
Quote:
Originally Posted by Rang_27 View Post
I've actually always wondered what normal pred dosage was for a human. I am not positive about addision's, but I thought I remember my vet saying that there has never been a cat diagnosed with addisons?? I do know that just like people pred can not be stopped suddenly or it causes problems. That's why I'm working with the vet to slowly get his doseage down.
I am on Hydrocortisone now, because pred does bad things to me. I'm on 30mg (15mg twice per day because it has a short half life), which is equivalent to 7.5mg of pred, and that is the highest they will let me go. Any more and I will start becoming "Cushings".

At least in humans, even if cortico-steroids are stopped slowly, if they have been taken for a long time the adrenal glands stop working and you end up with Secondary Addison's Disease. Secondary meaning it was caused by a non-natural origin, I have Primary Addison's from adrenal antibodies that have attacked and destroyed my adrenal glands. Normally this only happens with individuals that take extremely high doses due to asthma, such as 40mg, etc. It has been known to happen with people taking lower maintenance doses though also.
post #27 of 27
Quote:
Originally Posted by Momofmany View Post
My vet keeps assuring me (I worry a lot), that pred is far easier on cats than it is on either dogs and humans. The risk you read most about is diabetes, which according to my vet, is usually self healing after a few months in cats.

I just keep reminding myself that the alternative (no pred) is worse.
That is true! I looked it up and it says that Addison's Disease is very rare in cats, but then again it says the same thing about AD in humans. lol It took close to two years and two doctors to diagnose me, because my first doctor insisted I was way too young to have it. My second doctor diagnosed me on the second visit. lol I was the only patient my second doctor had ever had with Addison's Disease, same with my current doctor.
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