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

Midi and I are sending healing thoughts to you and kitty.  

samus said:

 
What dosage/weight was your cat on? So far I haven't seen any effect from the 8 mg pill I gave her earlier today. Still nibbling and meatloafing. But maybe there are absorption issues from the gut problems?

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I can't speak for the condition your kitty has. For kidney cats, the dosing is 1/8-1/4 of a 16mg tablet (so surprised when you said that was a two-day supply). I had injections for Lucky which I gave with the subqs, much easier for him. 

Nausea meds are not appetite stimulants, so they will not increase appetite. They will only make the nausea go away, enabling them to eat or to be syringe-fed (the latter was the case for Lucky). Inappetance takes a bit of work to resolve, but nausea meds are a start to the treatment. Then if needed, famotidine (or omeprazole) can be given for hyperacidity. And then finally, appetite stimulants can be tried. 

Regarding famotidine (Pepcid) vs omeprazole (Prilosec), they are both OTC now, although people can get it via prescription. So not sure if that is a separate dosage, but going by the other forum I'm on for CKD kitties, the one used by them is OTC. I think some kitties just do better with omeprazole over famotidine.

Good to hear there MAY be a prescription food available to suit your girl. :cross: that she likes it

samus said:

 
She was tested for hepatic lipidosis when this all started about a week and a half ago, but not since. A feeding tube would get rid of some of my worries (like aspiration pneumonia) and give me new ones (I shouldn't have read that thread someone posted about her cat dying when it got back from getting a feeding tube put in). I went back to feeding baby food, even though this country doesn't believe in pure meat baby food so it's got rice. Hopefully that wasn't what was causing the terrible water poop earlier. Watered down blended normal cat food just doesn't have enough calories. I'm thinking about getting some lactose free cheese and seeing if that intrigues her appetite.

@Columbine my vet told me today that there is a prescription kidney food for cats with food allergies. Fingers crossed that it's for the same food allergies my cat has... and that she'll actually eat it. I didn't get the name of it, she has to special order it, it sounded like it just came out recently. Maybe I'm not the only one that's been calling/emailing cat food companies asking which limited ingredient flavor is least likely to kill what's left of my cat's kidneys.

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That thread was an outlier, and may have been connected to an overdose of baytril but regardless tube feeding is very safe.

samus said:

 
Watered down blended normal cat food just doesn't have enough calories. I'm thinking about getting some lactose free cheese and seeing if that intrigues her appetite.

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Maybe look into using Clinicare? There is also Clinicare RF which is specific to kitties with kidney disease. Run it by your vet of course. It's like Ensure for kitties. I may have said that earlier in this thread... I know I said it sometime in the past week but don't remember where, lol. So sorry if I'm repeating myself. Anyway, it lets you thin down the blended food without losing calories. Absolute worst case scenario, you could feed him that stuff straight even (again, with vet's ok) as it contains all the daily nutrients needed by a kitty. Like I said, kitty Ensure. Only downside is it's a tad on the expensive side.

Sorry...just catching up here and trying to read through the posts. Sebastian has been on Cerenia for over two years - 5 days on, 2 days off. His maintenance does is 1/4 of a 16 mg tablet. His sick dose is 1/2 of a 16 mg tablet; we've only had to use 1/2 tablet for two weeks, at most. He gets sub-q fluids at home - every two days maintenance; every day if sick. He's on many other things...

So...the pancreas levels you mentioned....were these part of the normal CBC? It's my understanding that these levels are not true markers of pancreatitis, but things are likely a little different where you live. I'm asking because the duodenum does lie parallel to the pancreas and I still wonder if there is irritation there. They usually see it on an ultrasound, but not always if it's mild. And even mild pancreatitis can make them feel pretty bad.  

Calcium levels are normal? I'm assuming yes since you said nothing else was out of range except eosinophils and creatinine.

In your first post, you said you had switched foods a few times. Did you check for recalls and complaints perhaps? Any new things, potentially toxic substances?

I'm just throwing ideas out there. You seem to have covered a lot, and I'm so sorry your girl is struggling. 

The few times Sebastian was pretty bad off, we go to town on addressing symptoms and getting nutrition in him ASAP - fluids every day, increase dose of Cerenia, add in Zofran (another anti-nausea) if needed, bring out the buprenorphine (for pain), also mirtazapine if he's sniffing the food (sort of interested) but walking away, no-joke syringe feeding, etc.

Is she on B12 injections? Might help to perk her up.

The liquid diet my vet gave me earlier in this mess is this stuff:

http://www.alfavet.de/katzen/appetitanreger/reconvalesr-tonicum-katze/

60 calories/100 g

I really don't understand how the recommended dosage is 45 ml (one bottle) a day, that's only like 30 calories!! Well, maybe a little more, not sure the density. But using it to thin out the other food might be a good idea. Not sure what grains might be in it (it just says something like "plant byproducts" for the plant part), though. And chicken might be an allergen. (And CliniCare has fish. )Arrgh!! But maybe instead of getting lactose free cheese I'll get lactose free milk and use that as the thinner.

Right now the problem isn't the appetite. She's so hungry!! But I just can't find what food she wants to eat (that won't make her stomach explode).... And she probably has that so hungry i'm nauseous thing going on. Tomorrow we're going to get to 100 calories!! I just know it! And this weekend I'm just going to stay home and put food in her face until we get to something like 150/day. I found a good blanket wrapping technique....

@GoHolistic They did a separate pancreas panel and everything was ok. (The doctor doing the ultrasound did double check with her main vet that the pancreas was checked, when she saw the duodenum area inflammation.) I didn't see any numbers for calcium.

And yes, the dumb food company changed their recipe!! It now has salmon oil and coconut flour. She's most likely allergic to fish, and coconut is actually pretty allergenic. (It's one of the most common allergies in India, where it's used on a daily basis by a large portion of the population.) The old recipe actually had whey in it and she was fine with it, so I think she doesn't have a milk allergy, at least.

I'm going to see if I can get the vet to give me the supplies for sub q fluids tomorrow, and I gave her B12 tonight. (She also had a B12 injection when I first brought her in a week and a half ago.) I think she probably needs something for pain, and all I have is the metacam that I'm scared of that I got from the vet that I dumped.

@StephenQ I know it's not normal for putting in a feeding tube to kill a cat, but since when does anxiety follow logic?

And thanks for that dose info, I was on the manufacter's website and couldn't find info on cat oral dosages, since the tablets are off-label in cats.

My cat wants CARBS!! I went to the store today to see what kind of lactose free stuff they had and settled on mascarpone, since it's really fatty and higher in protein/lower in sodium than cottage cheese. Not interested. But she's all over my table trying to eat my baba ganoush, full of olive oil AND GARLIC. And stealing my pita bread, pulling bites off and just dropping them. Did I mention that she licks all the cookies?  Dry food she'll eat one piece, and then roll the rest in her mouth and drop them. Maybe I should ask the vet to look at her teeth/gums? But it's essentially what she does with wet food, licks it, sometimes rolls a chunk around in her mouth before dropping it and walking away.

samus said:

 
My cat wants CARBS!! I went to the store today to see what kind of lactose free stuff they had and settled on mascarpone, since it's really fatty and higher in protein/lower in sodium than cottage cheese. Not interested. But she's all over my table trying to eat my baba ganoush, full of olive oil AND GARLIC. And stealing my pita bread, pulling bites off and just dropping them. Did I mention that she licks all the cookies?  Dry food she'll eat one piece, and then roll the rest in her mouth and drop them. Maybe I should ask the vet to look at her teeth/gums? But it's essentially what she does with wet food, licks it, sometimes rolls a chunk around in her mouth before dropping it and walking away.

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Garlic is toxic for kitties! So please don't let her eat that! 

The interest in food but walking away stuff is indicative of nausea. Lucky would be all over it, sniffing it like he just wanted to dig into it, and then would walk away looking dejected. 

That liquid food your vet suggested looks like it may be more supplemental than meal replacement? I know with Clinicare it can be used either way. Can't speak for this stuff, as I'm not sure what the nutrients in the recommended dosage are. Definitely still need more food though. And how much does your kitty weigh again?

It sounds like you and your vet have done some great detective wor and I am sorry she is still not feeling well.

Has your vet mentioned anything about her teeth? Maybe she is hungry but her mouth is painful so that is why she is not eating. It is hard to say without seeing the pet.

I don't know whether or not you are anywhere close to the point of a feeding tube but don't be afraid of it.  My kitty had one 5 years ago when he had fatty liver and he did very well with it.  He tolerated it well and feeding though slow was easy to do.  He is still here and doing well.  Every kitty and every kitty's medical issues are different..  

I know about the garlic and cats, I didn't let her do more than sniff it.

That liquid diet confused me too. I couldn't find where it definitively said if you can feed it exclusively or not. Or if the 1/2 to 1 bottle a day is for coming out of fasting? It might make sense for that.

Samus is around 3.1 kg, I still need to get a scale to weigh her myself. Lost less than 100 grams between last Saturday and yesterday's visit

She had a tooth cleaning in February (with anasthesia) and I regret it so much because that's when her health went really downhill. The next two vets after that didn't notice anything, but if she doesn't improve much over the weekend I'll ask the new vet to have a good look in her mouth when I bring her back in. (I'm so glad I decided to find a cat only vet! Pretty sure vet #2 was halfway into retirement, his office was only open half days. Third time's the charm.)

Did subq fluids for the first time ever. It was very uneventful. She just sat on the back of the couch and didn't even seem to notice, too busy sniffing some treats that smell really good but not quite good enough to actually eat. Then a little force feeding to remind her stomach what it's supposed to do and she's eating some solid cat food on her own! Too bad the one she decided she likes is the high phosphorous rabbit. Only about 5 grams so far, but that's 5 grams less I have to squirt in her mouth. I think we're around 70 calories, but there was a lot of mixing food going on trying to find something palatable so I wasn't able to keep track as well as I would have liked. Almost time for forced feeding number 3.... I'd consider a feeding tube if she wasn't eating at all on her own, but every day we're getting more food in her and she's doing more of it herself and I don't want the stress of a surgery that could force everything backwards.

sounds like things are improving slowly, keep up the great work. 

Arrrrrgh. The diarrhea's back. Probably from the baby turkey and rice food, but I also tried tempting her with stuff like nutritional yeast. I even gave it with probiotics to try to make it less likely to cause diarrhea. And while I was sleeping my partner gave her some croissant, because she was being a bully and attacking all the pastries. Today I'm going to the pet food store and buying all the limited ingredient food that I wrote off because of phosphorous. There's gotta be something she'll eat....

I hope the diarrhoea clears up quickly. Good luck with finding a food she'll eat

Just checking in...any update?

Still having diarrhea.   But she's eating a good deal more on her own. Yesterday I only fed her about 15 cal by syringe and she ate about 70 on her own. Still less than I think she should be eating, but she was vomiting the two days before so I didn't want to force feed too much. For the past two days she's been pretty into Catz Finefood Pork, so I'm trying to mix it with the Cat Sana Horse the vet thinks she should eat. The pork's too high in phosphorous to keep on with long term.

I've been giving her slippery elm bark since Sunday, it doesn't seem to do anything. Maybe because she drools out half the syringe.... Today I gave her a human probiotic with pectin (for diarrhea), along with another human probiotic that really helps when my stomach is bothering me. Previously I've been giving her Proviable, but it doesn't seem to be doing anything. Neither did the psyllium that the vet gave me for the diarrhea. I'm also going to start giving her glutamine. Not sure when I should do another B-12, I did one last Thurs (400 mcg).

The vet gave me some cyproheptadine for her appetite if it doesn't get better, but I really don't think it's the appetite that's the problem!! I think it's the nausea, or just plain pain. Yesterday I started her on prednisolone 5 mg/day, which my vet says is a pretty big dose (she's 3kg), and gave her a cerenia injection in her subq's. No vomiting, but still looks unhappy and nauseous when she eats.

Anyone know how long I should expect to want to see results from prednisolone? Today is day 3 of 5 mg and the vet wants to start tapering down tomorrow. But she's still not better, only really eats with a lot of prompting and since yesterday an appetite stimulant, still meatloafs after eating, still has diarrhea.....

Also how long can it take for diarrhea from food switching to clear up? I found a food she'll eat -pork - but she still has the diarrhea. It's melted chocolate,not water now at least....