Budesonide suspension doesn't work for colon inflammation

cat pal

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I started my cat Vivian on Budesonide suspension two weeks ago to address large intestine/colon inflammation, because prednisolone had induced diabetes. The good news is now that she's off the pred her blood glucose has normalized and she is off the insulin. The bad news is the budesondie suspension has not been effective and Vivian has back slid into a state of pretty poor quality poops with mucus and blood - so I can tell the inflammation is back. Talked to a pharmacist at compounding pharmacy who said definitely the drug in this formulation is absorbed or degraded long before it reaches the large intestine. Wish I had known that before I bought it and essentially took her off all meds, since it doesn't reach her trouble area.

I asked whether a capsule would remain intact further into the intestine and he said YES they can put the drug into a time released capsule that should last much further into the intestine. FYI - Budesonide liquid doesn not stay active long enough to treat inflammation of the lower intestine. And it's not really more expensive.

He said the fact that my cat hates liquid and is easily pilled is very unusual and almost all cat owners go for the liquid - huh - just letting you know if you have a cat in Vivian's situation, don't go with the liquid.
 
stephenq

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Cat Pal said:
 
I started my cat Vivian on Budesonide suspension two weeks ago to address large intestine/colon inflammation, because prednisolone had induced diabetes. The good news is now that she's off the pred her blood glucose has normalized and she is off the insulin. The bad news is the budesondie suspension has not been effective and Vivian has back slid into a state of pretty poor quality poops with mucus and blood - so I can tell the inflammation is back. Talked to a pharmacist at compounding pharmacy who said definitely the drug in this formulation is absorbed or degraded long before it reaches the large intestine. Wish I had known that before I bought it and essentially took her off all meds, since it doesn't reach her trouble area.

I asked whether a capsule would remain intact further into the intestine and he said YES they can put the drug into a time released capsule that should last much further into the intestine. FYI - Budesonide liquid doesn not stay active long enough to treat inflammation of the lower intestine. And it's not really more expensive.

He said the fact that my cat hates liquid and is easily pilled is very unusual and almost all cat owners go for the liquid - huh - just letting you know if you have a cat in Vivian's situation, don't go with the liquid.
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Talk to your cat about Dexamethasone given Sub Q. Well absorbed because its injected.   I'm assuming your cat has IBD?
 
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cat pal

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Vivian got diabetes from prednisolone, would be very ambivalen about injecting her with dexameth...
 
denice

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My kitty was put on dexamethasone orally when we couldn't get pred.  He was on it for about a year and his blood sugar started to go up.  At that point we could get the prednisolone so we went back to that.  His blood sugar came back down and stayed down.

I think I had posted in your other thread about what my vet thought of the Budesonide.  She tried it with kitties that were diabetic and needed a steroid.  She wasn't impressed with it and quit prescribing it.  I am not sure which one she tried, this would have been over 4 years ago, but she said blood sugar numbers went up the same as it did with the prednisolone.  I would think the time release would stay in the digestive tract longer which means more of it getting into the blood stream..
 
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cat pal

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Ya, definitely not a lot of empirical evidence out there on the effectiveness of this drug on cats' intestines, but there are a fair number of success stories if you look for them. I would agree that budesonide suspension is ineffective, but have had interactions with those who really speak favorably of how it helped their cat's IBD condition. With respect to getting in blood stream and raising blood glucose... here's what I"ve read -

Budesonide undergoes high first pass metabolism in the liver and 90% is converted into metabolites with low corticosteroid activity. It has minimal systemic availability. The potential for typical corticosteroid side effects is significantly reduced as a result of decreased bioavailability and the resulting limited systemic exposure, which makes this a particularly attractive drug for use in humans and animals that are poorly tolerant of other corticosteroids
 
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