Starting Prednosone

Can the folks with experience using pred please give me some advice with it.

I understand it acts as a diuretic.   With a cat that is not drinking on their own do you syringe water with the pred or give subqs?  It is important to avoid dehydration and I am afraid that prednisone will make matters worse.

My guy was on Prednisolone for a year or so and for him the only thing I noticed was he gain weight on it. He was on sub-q's back then so I don't know about dehydration because this was not an issue for him as such. He was switched over to Budesonide to see if this helped him a little more but the difference is the same. He added about .5 - .7 kgs when he is on either of these drugs. You can try the drug for a short period and see if there is any dehydration in the skin, if the mouth is getting dry, or if the eyes are getting dull and go from there. I like to reduce the stress of medications as much as possible and most cats don't like things stuck in their mouth.

Prednisone is mainly used as an anti-inflammatory and I've never heard of it being a diuretic.  My husband takes pred routinely and it makes him hungry, grumpy, and moody.  I gave it to my kitty for a week a couple of months ago and didn't notice any change in her urine output.  Basically, once you start it, give it exactly as directed and don't stop it suddenly.

Why did they give you that?  What were (are) your kitty's symptoms? 

stephanietx said:

 
Prednisone is mainly used as an anti-inflammatory and I've never heard of it being a diuretic.  My husband takes pred routinely and it makes him hungry, grumpy, and moody.  I gave it to my kitty for a week a couple of months ago and didn't notice any change in her urine output.  Basically, once you start it, give it exactly as directed and don't stop it suddenly.

Why did they give you that?  What were (are) your kitty's symptoms? 

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For IBD.  The cat wasnt eating.  Vomiting excessively  mostly lots of clear mucous liquid until there was no fluid left to vomit.   They gave her a subq with the bottle of preds for me to take home.   But she peed the entire subq outside the litter box right next to it a day later.    So I tried to make up by syringing water but I dont think its enough or absorbed quick like subq.    I thought I read on the prescription advisory that pred may increase urination and thirst.   But what if the cat is not drinking on their own?   It doesnt say anything about that.

My kitty has been on a steroid for 3 1/2 years for IBD.  He had the same type of symptoms with the vomiting.  He hasn't had any issues with dehydration.

Denice said:

 
My kitty has been on a steroid for 3 1/2 years for IBD.  He had the same type of symptoms with the vomiting.  He hasn't had any issues with dehydration.

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But he drinks heavily on pred - no?

Dehydration really depends on how well the cat takes in water and absorbs it properly. It has been pretty hot and my cat threw up three times in one day before he got his sub-q and I could see his eyes were dull and his mouth was a little dry and sticky. I can't really use the skin test because he is old and his skin is not like it was in the old days. Most of the IBD sites do caution that some cats can become dehydrated by throwing up so much water especially if they don't absorb it as well as they did. The Budesonide I am giving my guy is given and then chased with 3cc of water or food so it never hurts. If you are giving your pet wet food then it is probably 70 - 80% water so moisture will be less of an issue as long as the animal is eating.

could hit hi

When I check for hydration I stick my finger tip into the cheek pouch and check for moisture, it should be close to your own mouth so it is easy to check for. For the eyes my guy has shiny eyes with moisture around the edges and when he dehydrates his eyes go dull and he loses that line of moisture where the eye meets the lids. I would give your vet a quick call and tell them what you have learned and whether this is going to be an issue with your cat or not. My cat is getting sub-q's for renal issues but my vet did say that it can help with IBD as dehydration can be an issue with some cats. Because my cat gets sub-q's daily he barely touches his fountain until he has an IBD flare-up and then he will start hitting it and he goes hard at times. Most of the time it just comes back up but for the most part be doesn't drink a lot of water and he keeps hydrated.

It is always a good idea to research any drug and check with your vet. I did the same and some of the drugs could hit other areas that weak with him. The other thing that really helps my guy is B12 shots, this and sub-q's made the biggest difference for him.

I agree with the others, Pred isn't a diuretic nor will it make your cat drink more. It is a very effective drug for IBD and usually starts to work very quickly, within 2 weeks by causing weight gain due to nutrient absorption. There are 2 types of Pred, prednisone and predNISilone and in cats, they convert prednisone into prednisilone so most vets prescribe the latter so they don't have to make their bodies do the conversion.

If your cat has IBD it is the therapy of choice. My cat was losing weight like crazy and this reversed it in under 2 weeks and he remains on it daily maintaining a healthy weight.

As I know you are aware from other threads, there are other therapies for IBD but when there is weight loss, Pred is a good place to start along with diet changes etc.

StephenQ said:

I agree with the others, Pred isn't a diuretic nor will it make your cat drink more. It is a very effective drug for IBD and usually starts to work very quickly, within 2 weeks by causing weight gain due to nutrient absorption. There are 2 types of Pred, prednisone and predNISilone and in cats, they convert prednisone into prednisilone so most vets prescribe the latter so they don't have to make their bodies do the conversion.

If your cat has IBD it is the therapy of choice. My cat was losing weight like crazy and this reversed it in under 2 weeks and he remains on it daily maintaining a healthy weight.

As I know you are aware from other threads, there are other therapies for IBD but when there is weight loss, Pred is a good place to start along with diet changes etc.

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I called my vet and they said I should see improvement very quickly on prednisone usually 2-3 days.   Of course they gave me prednisone not prednisilone so maybe my cat couldnt convert it and it was useless as there was no improvement.  See below.....

From veterinarypartner.com

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Prednisolone may be administered in tablet form or produced by the body from prednisone. These medications are considered to be interchangeable though it seems that some cats are not efficient at the conversion and do better on prednisolone.

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Furthermore everything I have read seems  to mention its property as a strong diuretic.........

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Side Effects

Prednisone and prednisolone have activity in the kidney that leads to the conservation of salt. This creates the classical side effects of prednisone/prednisolone use: excessive thirst and excessive urination.

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What I saw in my cat - it drew every last drop of water out of her.    In my experience starting a cat on this drug can be dangerous if you are not prepared for its impact in dehydrating your cat.   Especially if she is not drinking enough in the first place.   Not being advised to have SubQ available can prove lethal.   

The excessive thirst and excessive urination I thought was due to the hyperglycemia caused by prednisone?  Non-diabetics sometimes have to go on insulin when on prednisone due to this effect.

The only instance I'm aware of pred being a diuretic is in heart failure.  It will work as an adjunct medication in pulling water off the cardiovascular system, and is an intended effect.  Otherwise, prednisone is known for causing fluid volume excess hence the edema most get while on it.  I puff up like the Goodyear blimp on it.

"I understand it acts as a diuretic" - Not that I'm aware of. As others of said a side effect is that it may cause the cat to drink more water (hence elminate more water). That's not the same as being a diuretic.

Watermelon and caffene are diuretics but they don't necessarily make you want to drink more water.


My senior cat has been on prednislone for over a year. He has always been a good drinker and doesn't drink significantly more water than normal. Hence, he probably doesn't experience as much of that side effect.

JClark said:

"I understand it acts as a diuretic" - Not that I'm aware of. As others of said a side effect is that it may cause the cat to drink more water (hence elminate more water). That's not the same as being a diuretic.

Watermelon and caffene are diuretics but they don't necessarily make you want to drink more water.


My senior cat has been on prednislone for over a year. He has always been a good drinker and doesn't drink significantly more water than normal. Hence, he probably doesn't experience as much of that side effect.

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The problem is if you start your cat on pred in the middle of an IBD flare when they are vomiting, not eating or drinking (and thus already dehydrated) then the pred side effect could lead to excessive urination - without the cat being able to make up the water loss on its own.    In my view this is a recipe for disaster.

peaches08 said:

 
The excessive thirst and excessive urination I thought was due to the hyperglycemia caused by prednisone?  Non-diabetics sometimes have to go on insulin when on prednisone due to this effect.

The only instance I'm aware of pred being a diuretic is in heart failure.  It will work as an adjunct medication in pulling water off the cardiovascular system, and is an intended effect.  Otherwise, prednisone is known for causing fluid volume excess hence the edema most get while on it.  I puff up like the Goodyear blimp on it.

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Hmmm...  would heart murmur qualify as `heart failure`?    My vet was aware of the fact that my cat had a heart murmur.   

All I know is there was a cup full of very dilute pee outside the litter box on the second day after I started her on prednisone.

zoneout said:

 
Hmmm...  would heart murmur qualify as `heart failure`?    My vet was aware of the fact that my cat had a heart murmur.   

All I know is there was a cup full of very dilute pee outside the litter box on the second day after I started her on prednisone.

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A heart murmur is an abnormal whooshing sound heard when listening to the blood flow through the heart.  Usually valvular and in of themselves not worrisome.  Heart failure is when the heart itself is unable to pump the blood effectively, and this is worrisome since it's a situation that feeds itself.  The heart can't meet the needs of the body, so it tries harder to pump but can't, leading to more damage/failure.

I can't dispute what you saw and it is awfully coincidental.  She may have had another condition not yet identified?  The dilute urine could be from hyperglycemia.  I truly don't know in your case, aqll I can do is provide generalities of the drug's use and effects.

zoneout said:

The problem is if you start your cat on pred in the middle of an IBD flare when they are vomiting, not eating or drinking (and thus already dehydrated) then the pred side effect could lead to excessive urination - without the cat being able to make up the water loss on its own.    In my view this is a recipe for disaster.

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It's shouldn't be a problem if you also give the animal an anti-nausea med (Covenia) and subQ fluids at the beginning. Then canned food, which can be thinned out if needed.

zoneout said:

 
Hmmm...  would heart murmur qualify as `heart failure`?    My vet was aware of the fact that my cat had a heart murmur.   

All I know is there was a cup full of very dilute pee outside the litter box on the second day after I started her on prednisone.

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A Heart murmur does not qualify as heart failure, it might not even be an issue at all.  Congestive heart failure is generally defined as a heart that is so incapacitated that fluid starts to backup into the lungs.

JClark said:

 

zoneout said:

 
The problem is if you start your cat on pred in the middle of an IBD flare when they are vomiting, not eating or drinking (and thus already dehydrated) then the pred side effect could lead to excessive urination - without the cat being able to make up the water loss on its own.    In my view this is a recipe for disaster.

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It's shouldn't be a problem if you also give the animal an anti-nausea med (Covenia) and subQ fluids at the beginning. Then canned food, which can be thinned out if needed.

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Just a small technical correction: i think the anti nausea med you're thinking of is Cerenia.   Covenia is a long acting antibiotic.  The should have come up with better names

@Denise, what dose of pred is your kitty on?

Zoneout, pred can increase appetite and thirst.  You did not say if you are feeding your cat canned or dry food.  I always feed canned, because there is water in the food, and I have to worry less about dehydration.  Also, I am in the habit of pouring a little water over the canned food for both my cats, just as an extra precaution against dehydration.

myrnafaye said:

Zoneout, pred can increase appetite and thirst.  You did not say if you are feeding your cat canned or dry food.  I always feed canned, because there is water in the food, and I have to worry less about dehydration.  Also, I am in the habit of pouring a little water over the canned food for both my cats, just as an extra precaution against dehydration.

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Yes, it is clearly indicated on the prescription bottle label  `May cause increased thirst and urination.`   So what????   How is knowing that supposed to have helped me (my cat)??

I was feeding her raw.    Everyone seems to be missing the point though.....   she was not eating or drinking as she was in the grips of a severe IBD flare.   The only food she was getting was a jar of baby food I syringe fed daily.   For fluids I was syringing a mixture of pedialyte with water.    Heavy vomiting of clear fluid.   Soooooo.... she was severely dehydrated from the IBD flare (heavy vomiting + not drinking on her own = dehydration).   

I brought her to the vet who gave her a subQ and handed me a bottle of pred.     I started the pred that evening and the next day she urinated next to the litterbox what looked like a volume of pee = volume of the subQ.   

So the label warning is correct `May increase urination`.  However the part about increased thirst had not kicked in - nor had my vet advised me to come back for more subQs.   She only said I should see improvement in 2-3 days and so I became falsely optimistic.    A few hours after urinating her entire subQ is when she likely had a stroke from dehydration and died later that day.

So I am trying to wrap my mind around what the pitfall is in order to hopefully spare another cat the same fate.    It seems what others are saying is that they:

A) did not start pred while the cat is in severe flare - heavy vomiting and not eating or drinking on their own  (in other words cat was already stablIized before they started pred)

B) started pred during flare but were also aware of what to do to rehydrate the cat after sudden and excessive urination.

C) were using other meds to control symptoms until the pred could kick-in.

D) just by chance were lucky enough that their cat was immune to this excessive urination side-effect.

I am so sorry to hear this,  it is terribly sad and distressing.  Do you know if her kidneys were functioning?  That is the only thing I can think of.  Most cats should be able to process sub Q fluids; and I believe that pred can also adversely effect kidneys, but it is unlikely that that happened - overnight - from the pred... :  (