My cat with IBD has been vomiting hairballs frequently and I'm getting concerned.

MommyTabby said:

 
That’s great to hear that, StephenQ!

I always hope to reduce the dosage of the pred for her, I’m afraid of the side-effects. But you are right, the pred helps her a lot! Actually, she wants to eat more food!! If I feed her more, she would be so happy! But one of the side effects of the pred is diabetes. I guess I shouldn’t feed her a lot, right?! I feed her around 300kcal per day. She’s around 8 lbs, so 240kcal per day must be good for her, but she needs to gain some weight, so my vet told me that’s okay. Thank you again for your help!

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My cat was on Pred for 15+months and we never had a diabetes issue, and my vet said that it's a fairly rare side effect. Perhaps more common are side effects from a suppressed immune system like new infections, but my cat didn't get that either.  A cat on pred should have regular exams and blood/urine work done, mine went in every 3 months.  Cats with IBD need to gain or maintain weight, so i wouldn't[t worry too much about over feeding her so long as she doesn't become obese.

Tapering Pred over time is a worth goal, but one that can't always be achieved, there is usually a dose below which your cat starts to slide into trouble again.  Nothing cures IBD, Pred can at best control it, so you are looking for a dosage that controls it.

I can't say this enough to people with IBD cats.  you can catch your cat's current condition or decline faster than by going for regular vet visits by spending $45 +/- on a baby scale and weighing your cat weekly.  If your cat is stable weekly, and then you see even a few ounces loss (even though the cat is eating the same etc) then you have caught a decline before the vet and you can then go to the vet for early intervention.  That loss is due to a decline in your cat's nutrient absorption ability and that's what the vet needs to intervene on, possibly with an adjustment to pred, or other diagnostic work.

One of many is shown here at Amazon. 

My kitty has been on a low dose of steroid for 4+ years and so far so good.  He was on dexamethasone for about a year because of supply issues with prednisolone and at the end of the year his blood sugar did go up.  It wasn't enough to be diabetes but it was high.  His blood sugar came back down when he went back on the pred,  He had a 6 1/2 year battle with undiagnosed IBD.  He had severe flares with symptoms that mimicked foreign body ingestion and the last flare went into fatty liver disease. His started when he was only 18 months old..  During that time I tried the diet changes none of which helped.  There was no rhyme or reason to his flares.  He has been fine on the steroid and I have accepted it has a lifelong thing.  He is down to 2 1/2 mg a day.

Many vets do an every other day dosage.  I understand the reasoning behind it.  The body produces it's own when the level falls too low,  by giving every other day the level falls enough that the body produces it's own.  My kitty continues to take it daily and as long as there are no issues with it I plan on continuing it.

Denice said:

 

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I will tag onto Denice's helpful post by pointing out that dexamethasone is more powerful than Pred and may be more likely to create long term issues....

StephenQ said:

 
My cat was on Pred for 15+months and we never had a diabetes issue, and my vet said that it's a fairly rare side effect. Perhaps more common are side effects from a suppressed immune system like new infections, but my cat didn't get that either.  A cat on pred should have regular exams and blood/urine work done, mine went in every 3 months.  Cats with IBD need to gain or maintain weight, so i wouldn't[t worry too much about over feeding her so long as she doesn't become obese.

Tapering Pred over time is a worth goal, but one that can't always be achieved, there is usually a dose below which your cat starts to slide into trouble again.  Nothing cures IBD, Pred can at best control it, so you are looking for a dosage that controls it.

I can't say this enough to people with IBD cats.  you can catch your cat's current condition or decline faster than by going for regular vet visits by spending $45 +/- on a baby scale and weighing your cat weekly.  If your cat is stable weekly, and then you see even a few ounces loss (even though the cat is eating the same etc) then you have caught a decline before the vet and you can then go to the vet for early intervention.  That loss is due to a decline in your cat's nutrient absorption ability and that's what the vet needs to intervene on, possibly with an adjustment to pred, or other diagnostic work.

One of many is shown here at Amazon. 

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Meow, StephenQ!!!!
Thank you soon much!! It’s so incredibly helpful tips that catching my cat’s condition by weighing her weekly! Actually, I got the same baby scale about two weeks ago, and weighing her almost daily basis! I feel much better now, and I guess I can feed my cat a bit more for her next meal! I’m sure she’s going to love it! Thank you so much again! 

Denice said:

 
My kitty has been on a low dose of steroid for 4+ years and so far so good.  He was on dexamethasone for about a year because of supply issues with prednisolone and at the end of the year his blood sugar did go up.  It wasn't enough to be diabetes but it was high.  His blood sugar came back down when he went back on the pred,  He had a 6 1/2 year battle with undiagnosed IBD.  He had severe flares with symptoms that mimicked foreign body ingestion and the last flare went into fatty liver disease. His started when he was only 18 months old..  During that time I tried the diet changes none of which helped.  There was no rhyme or reason to his flares.  He has been fine on the steroid and I have accepted it has a lifelong thing.  He is down to 2 1/2 mg a day.

Many vets do an every other day dosage.  I understand the reasoning behind it.  The body produces it's own when the level falls too low,  by giving every other day the level falls enough that the body produces it's own.  My kitty continues to take it daily and as long as there are no issues with it I plan on continuing it.

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Hi Denice, 
Thank you so much for sharing your story. It’s good to hear that your kitty has been on a low dose of steroid for four years!  I’m sorry that there was the supply issue with Pred back then and your kitty blood sugar did go up. I hope it won’t be happening again. 

“There was no rhyme or reason to his flares.” 

Maybe from stress? weather?? I don’t know… I really hope one day you can figure it out for your kitty. If you did, please let me know. I’m scared just to think about the flare. I’m sure you know this already, but I’m feeding her four times a day, every six hours. I think it’s good for her IBD. 

Wonderful information from all of you that have posted.  My cat, Rube, has issues with hairballs and only hairballs.  He was initially diagnosed with suspect IBD in November and an ultrasound show some enlargement of the small intestine.  Based on some suggestions that the vet gave me and invaluable information that I found here, I switched his diet to something the vet suggested and started him on Organic Slippery Elm bark.  At the end of January, I returned for a follow up and an ultrasound showed no further inflammation of the small intestines.

After doing further research, I switched him from the vet-prescribed food (the dry contained soy and the canned contained carrageenan) to a limited ingredient diet from Nature Variety.  Like some folks have mentioned, every cat is different and this disease is an ugly, shifting disease with ups and downs.  FOR ME, the combination that I have found that works best is frequest, small meals and a combination of:

1/4 tsp SEB organic powder + 1/4 tsp NaturVet digestive enzymes + 1 capsule of Provobial DC probiotic + 1 capsule of Swanson Egg Yolk Lethicin  given to him before his main evening meal 30 minutes before feeding him.  And we've gone from daily hairballs to about once/twice weekly, sometimes much less (depending on his stress level) and hairball season.

He's due to go in for a weigh in but I can tell by sign and feel that he has not lost weight and my boyfriend agrees (who is brutally honest and in all this, he is my sanity check).  I am doing everything in my power to keep him off steroids but after reading your stories, I'm now starting to see them as a godsend rather than a death sentence.  The whole idea of steriods scared me almost as much as the IBD because of their reputation of destroying kidneys, etc.

He HATES to be brushed....but I did find some purple, rubber brushes with extra large teeth that basically massage the cat as well as remove hair and they  have been a godsend.

One question that I have for someone who may know.....I've read about the incredible help the probiotic strain S. Boulardii has for cats with diarrhea but Rube doesn't have diarrhea problems, just those darn hairballs.  Could S. Boulardii help that as well?  It's a completely different strain than the others he's taking so I'm interested on hearing opinions about that.

MommyTabby said:

 
Meow, StephenQ!!!!
Thank you soon much!! It’s so incredibly helpful tips that catching my cat’s condition by weighing her weekly! Actually, I got the same baby scale about two weeks ago, and weighing her almost daily basis! I feel much better now, and I guess I can feed my cat a bit more for her next meal! I’m sure she’s going to love it! Thank you so much again! 

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Wow my first meow!  That's great that you are weighing her, daily might be a bit more than is needed but do as you see best

mphscat said:

 
Wonderful information from all of you that have posted.  My cat, Rube, has issues with hairballs and only hairballs.  He was initially diagnosed with suspect IBD in November and an ultrasound show some enlargement of the small intestine.  Based on some suggestions that the vet gave me and invaluable information that I found here, I switched his diet to something the vet suggested and started him on Organic Slippery Elm bark.  At the end of January, I returned for a follow up and an ultrasound showed no further inflammation of the small intestines.

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Hi, generally its a good idea to start your own thread lest the current thread lose its focus, but in answer to your question about steroids, they are not a death sentence at all.  First there are two types of steroids, anabolic and Corticosteroids.  Anabolic steroids are the type that build muscle mass and have bad side effects in people.  Prednisilone is a Corticosteroids which is entirely different, and while its associated with some side effects in people and to some extent in dogs, it has very few negative side effects in cats.

A cat who is losing weight to IBD is losing the battle to the disease and if the weight loss isn't arrested, in time death will follow.  Generally when a cat is consistently losing weight to IBD (and even more so has an ultrasound that shows enlargement of the intestinal wall) the only thing that will arrest and reverse this weight loss (particularly if diet has been tried) is prednisilone.  If it works, you will have weight gain quickly, usually measurable in a week, 2 at most.  As i mentioned above, a baby scale is very helpful at this time in your cat's life.  The goal of the Pred is to put the IBD into remission and delay the onset of small cell lymphoma which IBD is often a precursor to.  You do not  want your cat getting small cell lymphoma, or any other type of infiltrative cancer that can result from severe IBD that doesn't stay in remission.

If you want to biopsy for small cell lymphoma vs IBD that has to be done before you start Pred.  But you don't have to biopsy.  You can just choose to treat.  But based on what you wrote, its time to consider Pred.

Just agreeing with stephenq - Prednisilone is very well tolerated by cats. I had Cali on it (for a different illness),and I remember having long conversations with my vet about how it worked and possible side effects. It can make such a difference to IBD - really don't be scared of trying it for your boy.

StephenQ said:

 
You do not  want your cat getting small cell lymphoma, or any other type of infiltrative cancer that can result from severe IBD that doesn't stay in remission.

If you want to biopsy for small cell lymphoma vs IBD that has to be done before you start Pred.  But you don't have to biopsy.  You can just choose to treat.  But based on what you wrote, its time to consider Pred.

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Thank you for posting this. My vet specialist was really pushing to do an endoscopy & biopsy on my cat to see if it was cancer due to enlargement of the intestines on the ultrasound, but it could have been an episode of pancreatitis (the other vet said it was this) or IBD. She did say that if my cat wasn't eating still after Mirtazapine, she could prescribe Pred., but she minimized this and really pushed for the biopsy. My cat ended up eating just fine after I took her home until a week ago. The extra $1,500 cost for the biopsy was too high for me after just spending $3,300. Last week, I got really worried about my cat reducing her eating and got her Hill's a/d again and gave it to her a couple times and then she started eating more again and is now wolfing down a different Orijen kibble (normal amount). If the cat is eating, then is Pred. not needed? I am afraid to take my cat back to the vet specialist as she is very expensive and wants to do many tests. 

StephenQ said:

mphscat said:

 
Wonderful information from all of you that have posted.  My cat, Rube, has issues with hairballs and only hairballs.  He was initially diagnosed with suspect IBD in November and an ultrasound show some enlargement of the small intestine.  Based on some suggestions that the vet gave me and invaluable information that I found here, I switched his diet to something the vet suggested and started him on Organic Slippery Elm bark.  At the end of January, I returned for a follow up and an ultrasound showed no further inflammation of the small intestines.

Click to expand...

If you want to biopsy for small cell lymphoma vs IBD that has to be done before you start Pred.  But you don't have to biopsy.  You can just choose to treat.  But based on what you wrote, its time to consider Pred.

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Mphscat should still consider Pred? Even though the follow up ultrasound showed no further inflammation of the small intestines?? I was going to take my cat for a follow up ultrasound later on to see if her intestines still showed inflammation or if it was gone...

Yes, I am lucky enough that the last ultrasound showed no inflammation at all but the vet did want to keep his weigh monitored every other month (I'm past due but have an appt Tuesday...). And since the follow up in March, the hairballs have continued but MUCH less than then. He had gone several months with only a couple incidents until hairball season set in...but he's getting a check up all the same.

Is there any reason why you prefer pred vs budesonide which I understand has even fewer side effects?

Bonitababy said:

 
Thank you for posting this. My vet specialist was really pushing to do an endoscopy & biopsy on my cat to see if it was cancer due to enlargement of the intestines on the ultrasound, but it could have been an episode of pancreatitis (the other vet said it was this) or IBD. She did say that if my cat wasn't eating still after Mirtazapine, she could prescribe Pred., but she minimized this and really pushed for the biopsy. My cat ended up eating just fine after I took her home until a week ago. The extra $1,500 cost for the biopsy was too high for me after just spending $3,300. Last week, I got really worried about my cat reducing her eating and got her Hill's a/d again and gave it to her a couple times and then she started eating more again and is now wolfing down a different Orijen kibble (normal amount). If the cat is eating, then is Pred. not needed? I am afraid to take my cat back to the vet specialist as she is very expensive and wants to do many tests. 

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Generally speaking Pred is needed when the cat is loosing weight to IBD.  Some cats aren't eating due to the disease, and some are eating and still loosing weight, but when there is weight loss, pretty much the only thing that will stop it is the Pred.

StephenQ said:

 
Wow my first meow!  That's great that you are weighing her, daily might be a bit more than is needed but do as you see best

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Meow meow StephenQ! 
My cats love the baby scale!! It’s so easy weighting them. They think it’s their new bed!  How about your cats?
Yeah, I guess it’s too much to weighting Tabby dairy,,,XD She continues gaining weight, that makes me happy.

She was 7.1 lbs about a month ago, and now she is 8.0 lbs! My vet told me around 9.0 lbs are the good weight for her.   

Thank you so much for your kind attention. I learned a lot from you! 

Hi everyone, 
Here I would like to update on Tabby. 

Tabby hasn’t vomited for three days. I adjusted her feeding schedule. I feed her every 6 hours, four times a day. Whenever I see she does lick lips, (I think it’s a sign of nausea) I give her a small amount of food, which only happened this evening, and it worked. 

My cat’s next vet appointment is next week. The vet and I will discuss if we can lower the medication. I will ask the vet about slippery elm bark powder, and freeze dried treats!

Thank you so much for your helpful advice! 

Great news!! Let us know how the visit goes!

MommyTabby said:

 
Meow meow StephenQ! 

My cats love the baby scale!! It’s so easy weighting them. They think it’s their new bed!

 How about your cats?
Yeah, I guess it’s too much to weighting Tabby dairy,,,XD She continues gaining weight, that makes me happy.

She was 7.1 lbs about a month ago, and now she is 8.0 lbs! My vet told me around 9.0 lbs are the good weight for her.   

Thank you so much for your kind attention. I learned a lot from you! 

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Great news and happy to help. Yes licking the lips is a sign of nausea, and if giving her food doesn't help in the future, there are medications which will help.  I currently have only one cat, Jenny, a very happy and healthy blind from birth 3 year old.  Her adventures are public on her facebook page, just go to facebook and add jennytheblindcat

Stay in touch!

StephenQ said:

 
Great news and happy to help. Yes licking the lips is a sign of nausea, and if giving her food doesn't help in the future, there are medications which will help.  I currently have only one cat, Jenny, a very happy and healthy blind from birth 3 year old.  Her adventures are public on her facebook page, just go to facebook and add jennytheblindcat

Stay in touch!

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Wow, Jenny is so beautiful! 
That’s so nice that you went to the beach with her! 
You have a nice roof deck for her, too! 

Aww, I wish I can “Like” Jenny’s page, but I deactivated my Facebook account…
Thank you so much for sharing her adventures! 

Hope you are having a purrfect weekend with her! 

MommyTabby said:

 
Wow, Jenny is so beautiful! 

That’s so nice that you went to the beach with her! 
You have a nice roof deck for her, too! 

Aww, I wish I can “Like” Jenny’s page, but I deactivated my Facebook account…
Thank you so much for sharing her adventures! 

Hope you are having a purrfect weekend with her! 

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Thank you!  For those who are curious, when Jenny goes on the beach with us its on a remote island with no real dangers, and she is highly supervised and stays near us, although she loves the freedom of running without bumping into things. On our roof deck, we designed it with cats in mind so it is also quite safe and she is supervised there as well.

MommyTabby...how is your kitty doing?? Rube'scheck up went great and he's gained almost two pounds. He hasn't throw up in a couple of weeks now and I'm continuing the herbs that I mentioned above. Let us know how things are going.