Gut issues: Deciding whether to give my cat steroids (prednisolone)

samus

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My cat hasn't been eating for about a week. All the tricks that normally work will work one time and then she ignores it (new food, baby food, Fortiflora, grass powder). She's getting maybe 50-100 calories a day, weighs 3.35 kg now (down from 4.5 in April). I started hand feeding her yesterday. She had a similar episode in April, the vet (a different one than the current one) gave her a dexamethasone shot that helped her appetite for a few days. (And then her appetite went back down again for a few weeks before coming back up to a more "normal" level. I also switched her food twice in this period.)

Her bloodwork is normal except high eosinophils and very slightly high creatinine. Her urine is fine except for slightly abnormal (I think low) specific gravity. I know her kidneys are in the early stages of CRF.

The vet gave me some steroids to take home, with the option of giving them to her if she doesn't start eating again in the next day or so. BUT. She's recommending an ultrasound, and if I give my cat the steroids now they can change the ultrasound (and probable biopsy) results. She wouldn't be able to do the ultrasound until I think Wednesday. Besides that, she gave me antibiotics (I thought it was a UTI at first because she was straining to go to the bathroom) and a dewormer (milbemax). She also gave my cat an injection of Cerenia, B-12, antibiotics, subq fluids, and something from one or two other vials I didn't get a chance to ask about--that was Tuesday, and my cat actually ate on her own when we got home. (Three times!! Only 30-50 cal snacks though.)

So my options:

1) Assume it's food allergy related IBD, use the steroids now to help her transition to a new protein, skip the ultrasound, maybe get her blood checked again in a couple months to see what her eosinophils are doing.

2) Start the steroids now and do the ultrasound next week

3) Hold off on the steroids and get the ultrasound

Is it even worth getting the ultrasound if I start the steroids now? I have a strong feeling it's allergy related, and that it's from the "improved recipe" in the food I've been feeding her adding salmon oil. But maybe there are other issues the ultrasound could uncover? If I get the ultrasound, I'll need a biopsy anyway, right? (unless it shows some obvious blockage type thing)

I'm on the verge of crying because she just came and sat in my lap even though I force fed her about fifteen minutes ago. She doesn't hate me!!
 
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samus

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I forgot to mention, when the vet felt her abdomen she said it felt like she had a lot of hard poop in there (hadn't pooped in almost 72 hours, but also hadn't really eaten/drank in that time) and gave me psyllium capsules to mix with her food. That's part of why the vet wants to do an ultrasound. But after giving her the psyllium, she had a GIGANTIC solid poop so maybe it's all out now anyway? (It's diarrhea now, probably because the antibiotics.)

Her pancreas levels were included in the test (glucose, cholersterin, fructosamine, and pancreatic lipase) and were normal, so at least pancreatitis looks ruled out.
 

Columbine

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Th diarrhoea could simply be down to the constipation. It sounds odd, but when there is significant constipation the 'newer' poop builds up behind it, often getting softer and softer. You might find she firms up again now everything has cleared out.

I really don't have an answer for you about the steroids though. Her improved appetite after the injections could well be down to the B12. I've seen it get cats (and dogs) eating time and again.

I think my instinct would be to hold off on the steroids, at least for a few days, simply because of the number of drugs currently in her system. If you can get enough food into her by hand feeding then stick with it for now. It's not such a long time til Wednesday, and she's clearly not holding the syringing against you!

Hang in there. You will get her through this :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes:
 
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samus

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Thanks. :) I'm also worried that if I start the steroids, I'll need to keep her on them for the rest of her life. (I'm working my way through the IBD/lymphoma book of a thread....)

She never had a problem losing weight when I was feeding her dry food.... Siiiigh.
 

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Here is my opinion based on my experience.

Hold off on the steroid.

The ultrasound is key to diagnosing IBD, which is exactly what it sounds like is going on.

You do not need a biopsy.

Once IBD is confirmed, you will know from this point the complete change in diet needed, which may be all that is needed.

Not all IBD cats recover with diet change alone, but mine sure did.

The idea is stop feeding what she is reacting to, allow her system to settle down, and getting her on a single protein source limited ingredient diet that she was not fed prior.

My Krissy developed a reaction to chicken and fish.

Now more than a year later since diagnosis is doing great on turkey fancy feast classics and blue buffalo limited ingredient turkey dry.

I chose not to start steroids or other meds and diet alone has worked, lucky for that.
 
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zed xyzed

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poor little thing, antibiotics really messed up my kitties tummy, he had runny bum and stopped eating after day 3. I hope she gets better soon. Let us know how she is doing  
 
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samus

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She's fine as long as she doesn't have to look at food! She totally barfed up her antibiotics on me this morning. I think because I tried to mix some Saccharomyces boulardii in with the food I was syringing her. She acts like it's poison and foamed up at the mouth when I tried to feed it to her. Great. Trying to make her diarrhea stop makes her vomit.

Actually, she has an appetite, just not for cat food. I was eating tortilla chips earlier and she jumped up on my desk and stuck her head in the bag. And she was harassing me earlier when I ate some toasted seaweed. If she could live off chips and seaweed we'd be good....

40 calories in so far today. Feeding her is so slow, it took about an hour to get just 12 ml of watered down baby food into her. I don't know if it'd be less stressful to feed her faster and risk squirting food in her lungs or hurting her mouth from trying to open it. I did end up getting some S. boulardii in her. I feel like the antibiotics are killing her, from dehydration and from making her even less into food. I was thinking of trying to find a lactose free cheese to feed her, but the grocery nearby was out. (I offered her yogurt and she wasn't interested at all.)

I went by the vet today to try to get some antinausea or appetite stimulant drugs, but she said I should just go ahead and use the steroids. But I'm worried about what multiple people said in the other IBD thread, about if you stop steroids after they were working, they frequently don't work as well when you start up again. I feel like if I give her the steroids now, I'm making the decision to give them to her for the rest of her life. Before seeing the ultrasound and having all the information. And when maybe just stopping the antibiotics will let her stomach get back to the point where she'll eat on her own.
 
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samus

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I spoke too soon, I thought I'd gave her enough time to calm down from the last feeding and put some food in front of her face, and she just vomited everywhere. Pretty good sized hairball along with it. But now it's like I have to go backwards and redo what I just did. Uuuuuuuuuuggh. I don't know if I should give her another dose of antibiotics. I didn't SEE a pill, but maybe it was dissolved but not absorbed yet. I might just stop the antibiotics anyway.
 

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:( Sorry she's still not good. My advice would be DON'T re-give the antibiotic. You've no way of knowing how much has been absorbed, and too much can do just as much (if nor more) harm than too little. Pick up with the next dose at the usual time.

Also, please don't discontinue the antibiotic without speaking to the vet. Stopping a course part way through can cause all kinds of issues - not least of which is helping to create resistant strains of bacteria; potentially causing problems with future treatment.

I really do understand your wanting to stop using it - just ask your vet first.

I really hope she starts doing better soon. Mega :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes:
 
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samus

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I know all about antibiotic resistance, I'm really not sure if she needs the antibiotics though. When I took her to the vet on Tuesday, I thought she had a UTI and the vet gave her a shot of some antibiotics for that while we waited for the urine culture results. Yesterday she prescribed 8 more days of antibiotics, but never told me the full urinalysis results. Kind of annoyed by that. I think if it were positive she would have said something, though, we had a phone conversation about her blood test results and she only mentioned the specific gravity being off in the urinalysis. So since she didn't tell me my cat has an infection, I feel like we're giving it "just in case," which is a horrible reason to give antibiotics (especially when they're making my cat's other issues even worse).

I'm going to call again tomorrow and get them to give me the FULL results (and tell me exactly what kind of medications they injected Tues), I'll ask about the antibiotic then.
 

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Absolutely - 'just in case' is the WORST reason to give antibiotics, especially when the patient isn't handling them well. I hope you get some answers from your vet tomorrow.
 

catwoman707

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In the time between suspected IBD by the vet and Krissy's ultrasound confirming it, she was also put on clavamox.

Krissy did okay the first few days but then started vomiting after every dose, so when I called and told her vet she stopped them.

Not sure she ever needed it anyway but was given on a 'just in case' basis.

However your vet may have evidence of a uti and/or other reason behind giving it to her, so be sure to let the vet know what is going on and whether to continue/or not or even switch the kind.
 
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samus

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I took her in to the vet today and she got so many injections. Steroids, a new antibiotic, cerenia, H2 blocker, plus some fluids. The vet said it was more urgent to treat the symptoms with the steroid now, next week we'll do the ultrasound. Hopefully she'll actually eat now.... I got about 15 ml into her this morning, then about two hours later she exploded it out both ends (conveniently right before leaving for the vet). She watches me in the kitchen like she's hungry but then just tries to bury whatever I give her. I still don't know exactly why we're doing an antibiotic, the vet said the urinalysis wasn't strongly indicating a UTI (no blood, not cloudy), but since it wasn't a sterile sample (she peed on the the table at the vet's) there's no way of telling if the bacteria detected were from inside her urinary tract or not.
 

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I'm glad you got to see the vet today. At least you have a better understanding of what drugs she's had and why now.

I'm so sorry she's still bad. :cross: that the steroids start making a difference soon :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes: :vibes:
 
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samus

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SHE ATE 30 g OF FOOD!!!! FROM A BOWL!!! I really want her to get about 100 g in today, though, trying to decide if I should force feed her some.... Trying really hard to be patient. She lost 200 grams since last vet visit (about half a pound), and that was last Tuesday.
 

Columbine

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:woohoo: That's great! Eating on her own is a wonderful sign.

Maybe leave it an hour or so before syringe feeding - you don't want yo overload her delicate stomach at this stage. Little and often is probably safest. :cross: that it all stays down :vibes:
 
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samus

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Cat Sana Horse, which is new for her. Not sure how well it'll syringe, but I do have a blender....
 
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samus

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Thursday I get to make the decision whether or not to get an ultrasound. Saturday she had a shot of dexamethasone, and the vet today said she's doubtful the ultrasound will show anything, since she's been on steroids for almost a week and the inflammation is down enough that she's eating. But she's still "meatloafing" after eating, so it's clearly not completely gone.

Think I should do the ultrasound? If I don't, I'll most likely be putting her on more steroids Thursday, which would make any further ultrasounds even less likely to be conclusive. Is five days of a steroid shot long enough to reduce the swelling so we can't see what's going on?

Her current status:

Ate 30-40 calories wet food on her own (!) this morning (past two days it was only about 40 calories all day, so today's looking really good so far). Soft but formed poop, after three or four days of liquid. No vomiting since Saturday.

Current meds:

dexamethasone shot from Sat

marbocyl (antibiotic)

omeprazole
 
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catwoman707

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That's a tough call really, clearly the inflammation is down now, whether it's enough that nothing will be seen on the ultrasound is unknown, although I would personally do it regardless because there are things they might see, as long as she is very experienced at reading the US, she might be able to see changes like thickened bowel loops/intestinal wall, pancreatitis, etc.

I'd say now rather than later is your best bet here.

Or you can continue treating it as IBD and skip the US.

Either way I'm glad she is eating and seems to be doing better.
 
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