Success with Leukeran Anybody?

cat pal · Jun 14, 2015

For those who have read about Vivian the cat, nothing really new here, just trying to get the attention of leukeran/chlorambucil users.

If you have a cat who has had success with Leukeran I'd love to hear about it.

Specifically, my cat Vivian has been on 5 mg prednisolone for 3+ months to treat intestinal disease, with resulting symptoms of frequent and loose stool with fresh blood. The pred helped symptoms a lot, though they did not completely resolve. Unfortunately the pred has pushed Vivian into a diabetic state and she needs to taper or stop taking it. So we have started her on 1.8 mg chlorambucil (aka Leukeran) M-W-F and will begin to taper pred very soon. Since starting chlorambucil/leukeran Vivian has experienced decreased appetite and some minor GI issues. It is also possible the insulin she now takes is causing or contributing to the problem because her blood glucose levels have gotten too low for comfort - we're working on that - but my question about chlorambucil/leukeran is this. Does anyone have a cat who went on this drug, experienced decreased appetite and eventually bounced back and regained normal appetite? I need to taper the pred and find a suitable replacement, but she can't afford more weight loss.

thanks!

stephenq · Jun 14, 2015

Cat Pal said:
For those who have read about Vivian the cat, nothing really new here, just trying to get the attention of leukeran/chlorambucil users.

If you have a cat who has had success with Leukeran I'd love to hear about it.

Specifically, my cat Vivian has been on 5 mg prednisolone for 3+ months to treat intestinal disease, with resulting symptoms of frequent and loose stool with fresh blood. The pred helped symptoms a lot, though they did not completely resolve. Unfortunately the pred has pushed Vivian into a diabetic state and she needs to taper or stop taking it. So we have started her on 1.8 mg chlorambucil (aka Leukeran) M-W-F and will begin to taper pred very soon. Since starting chlorambucil/leukeran Vivian has experienced decreased appetite and some minor GI issues. It is also possible the insulin she now takes is causing or contributing to the problem because her blood glucose levels have gotten too low for comfort - we're working on that - but my question about chlorambucil/leukeran is this. Does anyone have a cat who went on this drug, experienced decreased appetite and eventually bounced back and regained normal appetite? I need to taper the pred and find a suitable replacement, but she can't afford more weight loss.

thanks!

Just a question, can you treat her diabetes and keep her on the pred? Diabetes can be well managed? Also here is a link to a well known and well respected vet who specializes in cats in NYC, and htis article is about the positive aspects on leukeran.

http://catexpert.blogspot.com/2013/01/leukeran-price-gouging-causes-feline.html

cat pal · Jun 14, 2015

What I am learning today is that Vivian's blood glucose has gone so low that even .5U lantus seems to be too much. So maybe it will be possible to reduce the insulin and taper but not eliminate pred without causing all of her GI symptoms to return. I'm not really familiar with how one tapers pred, go to every other day or reduce daily dose? Ideally she could taper pred to the point where BG drops back to normal and GI symptoms do not return, you never know. Even on full pred though she had blood at end of bowel movement (tiny amount) and looser stool as recently as this morning. As for continuing pred and insulin, I REALLY would prefer not to go that route, but will if I have to. Insulin is super expensive, it has to be given every 12 hours and you can't ask your neighbor or your brother to stop in and do that so you can go on vacation, it is a potentially very dangerous med, as I am finding out today with Vivian's BG #'s dipping into the 30's, just all around not where I want us to be but we'll see - thanks for the link, will check it out.

jmarkitell · Jun 14, 2015

In Humans, Cortisone can cause elevated glucose levels, requiring higher doses of Insulin. With any decrease in Prednisone you will likely see a lowering of blood glucose levels. There could be a chance that there won't be a need for insulin medications once you get below a certain level of Prednisone. Until you see how the lowering of the Prednisone effects Vivian, you might want to error on the side of caution and keep her blood glucose a little on the high side to make sure she doesn't get too low and suffer any bad reactions. With most Prednisone decreases, the reduction is usually around 15% every 3 or 4 days depending on how long it has been used. A vet should provide the correct info, but this is the general rule I have followed in the past. Good Luck!

cat pal · Jun 14, 2015

I have actually read the article in that link, had forgotten some of it. Vivian was never on pred twice a day - just 5 mg once a day. So maybe we're going to reduce the 5 mg amount but stay on once a day? I'll find out soon. She does take chlorambucil (not name brand Leukeran) every other day.

As the article stated, the compounding pharmacies are not allowed to make 2 mg capsules b/c that's the size Leukeran tabs come in, so Vivian takes 1.8 mg capsules chlorambucil at a price much lower than that of Leukeran. What a racket - it's a little like Lantus for diabetes actually. They are the only company that makes glargine insulin, there is no generic, it's pretty much the best, and they charge an arm and a leg for it, because they can!! No price breaks on that one - I tried. They give significant discounts on the insulin pens to those with no insurance, but since Vivian isn't a human they wouldn't give her the discount - rats. Anyway, nice to read something positive about Leukeran, thanks!

Success with Leukeran Anybody?

cat pal

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stephenq

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cat pal

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jmarkitell

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cat pal

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