Dexamethasone AND Prednisone ?

My baby, Norman, was just diagnosed with cancer yesterday, 11/02/16.

I am completely heart broken and in shock. He was acting completely normal/healthy and I took him in for blood work prior to having his teeth cleaned on 10/29 and the vet felt a "mass" in his abdomen. After an ultra sound with an aspirate, our vet confirmed it is cancer.  I will have the aspirate results tomorrow but she is almost positive that it's Lymphoma. 

Yesterday the vet gave Norman a shot of Dexamethasone and sent us home with Prednisone to start today. Today he is acting like he doesn't feel good and I started researching Dexamethasone and it seems like it's not good to have that AND Prednisone? Does anybody have any advice or experience with this?   =(  

Here are some pictures of my baby. He is now 5 years old.....he is the sweetest, friendliest cat ever. 

Hi lisamarie66 and welcome to the forum !

Only people who have received the same kind of diagnosis can really appreciate just how devastating it is. I really feel for what you're going through right now.

Forums like this are a great starting point for many people who want to share experiences and receive basic cat health information.

When it comes to complicated feline health issues, there are also specialized online communities of caregivers who are dealing with all of the 'heavy duty' feline health conditions/diseases....and, obviously lymphoma/cancer is no exception.

If I were in your shoes right now, I'd be sharing Norman's story with these people: Feline Lymphoma Caregivers Support Group   They also have a website: FelineLymphoma.org

Now, I also hope you'll be able to keep us updated !

I see why you are in shock, since Norman must not be having any symptoms of Lymphoma, which i think is a GOOD thing, meaning if he does, indeed have it, it might be in the early stages, and with treatment, might mean he has more time with you than you think.  And there are two types of Lymphoma in cats.  Smell cell and large cell.  If it's small cell, the treatment is pretty easy, with few side effects.  If it's large cell, then often surgery and chemo are suggested, or hospice care.  But with cats, chemo isn't usually as bad as with humans, so there's that little bit of solice   We'll hope, if it IS Lymphoma,that it's small cell

lisamarie66 said:

 
My baby, Norman, was just diagnosed with cancer yesterday, 11/02/16.

I am completely heart broken and in shock. He was acting completely normal/healthy and I took him in for blood work prior to having his teeth cleaned on 10/29 and the vet felt a "mass" in his abdomen. After an ultra sound with an aspirate, our vet confirmed it is cancer.  I will have the aspirate results tomorrow but she is almost positive that it's Lymphoma. 

Yesterday the vet gave Norman a shot of Dexamethasone and sent us home with Prednisone to start today. Today he is acting like he doesn't feel good and I started researching Dexamethasone and it seems like it's not good to have that AND Prednisone? Does anybody have any advice or experience with this?   =(  

Click to expand...

I am a human doctor, not a vet and any advice that I give about cats should be checked by a vet as feline medicine can be different from human medicine.  However I have had over 60 years experience with steroids 

Both prednisone and dexamethasone are steroids, and have similar therapeutic effects on feline lymphoma.   As both the medications have the same effect there is little point in taking the two together except when it is necessary to produce a therapeutic dose immediately and an injection of dexamethasone will do that. On the other hand, prednisone, in tablet form, has a slower effect and would be given by mouth to maintain that therapeutic level. 

I doubt very much that the two medications, taken together, are the cause of Norman's malaise.

 With best wishes to you and Norman,

Geoffrey

lisamarie66 said:

 
...the vet...sent us home with Prednisone to start today

Click to expand...

lisamarie -

I somehow missed this: You should have been given Prednisolone...not Prednisone

 Prednisone is converted by the liver to prednisolone....Systemic prednisolone is preferred for use in cats over prednisone because there is some question if cats are able to convert prednisone to prednisolone.

http://www.wedgewoodpetrx.com/learn...nographs/prednisolone-for-veterinary-use.html

Click to expand...

 This question was raised by an American study group and evaluated carefully. The surprising result: oral prednisolone is the superior choice for cats!

http://www.vetcontact.com/dermatology/art.php?a=640

Click to expand...

** One other point (in case your Vet misses this too).....don't stop the Pred suddenly.....slowly taper off the dosing if/when it's no longer prescribed.

Prednisone is broken down in the human and feline body to Prednisolone - this is accepted.  However the first link: 

http://www.wedgewoodpetrx.com/learning-center/professional-monographs/prednisolone-for-veterinary-use.html gives no references. 

The second link:  http://www.vetcontact.com/dermatology/art.php?a=640   is a study on only six cats and this number is very small.  Prednisolone may well be the better medication for use in cats, but one would prefer a study using a higher number of cats before finally accepting this statement.

Geoffrey

White Shadow said:

 
Hi lisamarie66 and welcome to the forum !

Only people who have received the same kind of diagnosis can really appreciate just how devastating it is. I really feel for what you're going through right now.

Forums like this are a great starting point for many people who want to share experiences and receive basic cat health information.

When it comes to complicated feline health issues, there are also specialized online communities of caregivers who are dealing with all of the 'heavy duty' feline health conditions/diseases....and, obviously lymphoma/cancer is no exception.

If I were in your shoes right now, I'd be sharing Norman's story with these people: Feline Lymphoma Caregivers Support Group   They also have a website: FelineLymphoma.org

Now, I also hope you'll be able to keep us updated !

Click to expand...

Thank you so much.  I really appreciate you sharing those websites.  This is all so overwhelming and stressful and I want to make sure that I am making the best decision possible for my baby-Norm. 

Geoffrey said:

 
I am a human doctor, not a vet and any advice that I give about cats should be checked by a vet as feline medicine can be different from human medicine.  However I have had over 60 years experience with steroids 

Both prednisone and dexamethasone are steroids, and have similar therapeutic effects on feline lymphoma.   As both the medications have the same effect there is little point in taking the two together except when it is necessary to produce a therapeutic dose immediately and an injection of dexamethasone will do that. On the other hand, prednisone, in tablet form, has a slower effect and would be given by mouth to maintain that therapeutic level. 

I doubt very much that the two medications, taken together, are the cause of Norman's malaise.

 With best wishes to you and Norman,

Geoffrey

Click to expand...

Thank you so much for your reply! This made me feel relieved....one less thing to be worrying about. 

White Shadow said:

 
lisamarie -

I somehow missed this: You should have been given Prednisolone...not Prednisone

** One other point (in case your Vet misses this too).....don't stop the Pred suddenly.....slowly taper off the dosing if/when it's no longer prescribed.

Click to expand...

Good catch and you are totally right....I just checked and Norman was prescribed Prednisolone. Thank goodness!

Update on Norman~  He seems like he is feeling better/back to normal. Maybe he was acting yuckie just from the stress from all the vet visits, etc?

Sadly, the aspiration of his tumor showed that he does have High Grade Lymphoma =(

I just can't believe this is happening..... he showed no signs of being sick. The only thing that was worrisome is that he was losing a little weight over time even though he eats like a piglet.  In January 2016 he weighed 14.78 lbs, July 14.61 lbs and his recent visit in October he was 14.48. 

The ultrasound findings say, "There is an infiltrative concentric hypoechoic mass involving an approx. 8 cm segment of distal jejunum. The mass is not significantly obstructing the lumen of the bowel. The wall of the ileum and cecum are mildly thickened........ The characteristics of the mass are most consistent with lymphoma but other neoplastic cell types are possible. Splenic involvement may also be preset."

So, we are giving him 5mg of Prednisolone, twice a day. Our vet is going to check him on Friday and see if she can feel that the mass has shrunk. And then from there we are most likely going to add another drug.... I forget the name of it but I believe it's a chemo type drug?

Our vet doesn't believe that doing full blown chemotherapy would be the best choice because of the stress it would put on Norman and it doesn't usually give them much more time.

As of right now, I don't think that I want to do chemotherapy. From what I have read online most kitties go through it and only get MONTHS to live..... That is so terribly sad. I can't believe that we may lose him soon.....he is acting perfectly fine ='(

This is such a nightmare. 

I appreciate any advice on treatments or things I can do to help Norman....