IBD kitty

My 15 year old cat was diagnosed with IBD about 6 months ago.  He began a course of prednisolone and was doing quite well.  He became very sick about a week ago.  He has been very lethargic, and not interested in anything. He is eating and drinking, but will either vomit everything up and he also has explosive diarrhea about 3 times a day.  We've been to the vet three times this week.  He was given sub-q fluids twice, as well as a dexamethasone injection, and cerenia.  He is not getting any better. Our vet suggested to stop the pred and give him atopica/cyclosporin.  I asked her about tapering the pred, and she suggested that this was not necessary as his dose was very low (0.1 cc/ml twice daily..morning and night).  He has been on this dose for about 5 months now.  Is it safe to stop the pred immediately without tapering and begin giving him cyclosporin?  Any help with this is appreciated. I worry that stopping the pred. immediately, despite the dose, might cause further harm. He's already doing so poorly.  Does anyone have a similar story/experience?

bagheera2015 said:

 
My 15 year old cat was diagnosed with IBD about 6 months ago.  He began a course of prednisolone and was doing quite well.  He became very sick about a week ago.  He has been very lethargic, and not interested in anything. He is eating and drinking, but will either vomit everything up and he also has explosive diarrhea about 3 times a day.  We've been to the vet three times this week.  He was given sub-q fluids twice, as well as a dexamethasone injection, and cerenia.  He is not getting any better. Our vet suggested to stop the pred and give him atopica/cyclosporin.  I asked her about tapering the pred, and she suggested that this was not necessary as his dose was very low (0.1 cc/ml twice daily..morning and night).  He has been on this dose for about 5 months now.  Is it safe to stop the pred immediately without tapering and begin giving him cyclosporin?  Any help with this is appreciated. I worry that stopping the pred. immediately, despite the dose, might cause further harm. He's already doing so poorly.  Does anyone have a similar story/experience?

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The only downside to stopping Pred quickly (and btw I had a cat who battled IBD for a long time) is that any benefits your cat may be getting from it come to an abrupt end - but there are no withdrawal issues, it isn't addictive.

The dose you mention doesn't have a concentration, normally its expressed as mg's per ml,  but maybe he needs a higher dose.  5mg or higher is a common dose.  If you're giving as a liquid it could be expressed as 5mg/ml with the dose being 1ml or 2 ml's or whatever.  but a 0.1cc (cc is the same as a ml) is a volume of liquid not a concentration/dosage.

When IBD stops responding to Pred, the next drug (if other steroids don't work) is usually Leukeran aka chlorambucil. Cerenia is a great anti nausea drug but can be supplemented with Zofran (sub Q injection every six hours) along with pepcid ac, and sub q fluids, some of which you are obviously doing.

If your cat hasn't had an ultrasound lately, it may be time to do it (again).  The thing you can't do is biopsy at this stage, so if there is a concern that it has turned into small cell lymphoma, that is another reason to start Leukeran.

At a certain point i was doing daily sub q fluids at home often with injectable cerenia, zofran, B12 (weekly) and pepcid and that kept him going for a while. Eventually we got an unusual diagnosis of internal mast cell cancer via a needle aspirate of his lymph nodes, and at that point the battle was close to lost. Hopefully your guy will rally.