long term prednisolone?

Hello.

So, the saga of my poor IBD cat Teddy continues. A few weeks ago, he took a turn for the worse and I was rapidly losing hope. He'd lost 2+ pounds, was extremely lethargic, his persistent diarrhea was even worse - and he wasn't always making it to the litterbox, and then... he vomited blood. We did another dietary change (to w/d), but to no avail.

After much discussion with the vet, he started prednisolone last week. He didn't start improving until Tuesday - but the change is remarkable. Where he would sleep for all but a little time during the day (I know, cats love to sleep... but this wasn't normal Teddy behavior), and where he was hiding in the closet - now he is out and active, greeting me in bed in the morning, running around, and acting more normal than he has in weeks.

The vet has him on a high dose right now (10mg/day), coupled with amoxicillin which he finishes tonight. Next week, he'll move to 5 mg/day, then 2.5/day, then 2.5 every other day. The vet thinks he might require a daily maintenance dose, and that he might not make it to the every-other-day stage.

I don't like having Teddy on pills like this, but so far, it is the only thing that has lessened his diarrhea (his stool still isn't quite solid or formed, but it's no longer explosive liquid - gross, I know, but it tells you how far he's come) and helped him to act normal. He's nearly 9.5 years old, and has had a very rough time these last 2 years. I'm willing to do anything to help him feel better, and if this is it, I'll keep doing it.

So now to the question - have any of you had your cat on long term prednisolone? Have you had any problems with it? Or good success? I know every cat is different, and treatments seem to stop working for Teddy rather quickly, so I'm only cautiously optimistic at this point. As a hormone biochemist, I'm very familiar with the pros and cons in humans... but not cats.

Thanks.

I think its the same for cats as well. Im so sorry Teddy is having so many issues .... it may help if you take the pills to a compound pharmacy to have them made into liquid and they can even add flavor to it also. It might be a lot easier to administer. I hope things get better for you and Teddy

Originally Posted by Pami

I think its the same for cats as well. Im so sorry Teddy is having so many issues .... it may help if you take the pills to a compound pharmacy to have them made into liquid and they can even add flavor to it also. It might be a lot easier to administer. I hope things get better for you and Teddy

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Thanks.
We have a compounding pharmacy here that makes PJ (our other cat's) methimazole - I don't know why I didn't think about compounding the prednisolone. PJ's is fish flavored, which I'm sure Teddy would love. If he's still doing okay next week, I might do that.

I've been wondering the same thing about Raphael....his weight has been up and down a whole lot and his stool goes from reasonably formed but still very soft to explosive and lquid. We switched him to Wellness Chx and are now doing a mix of that and Evanger's Turkey/Squash (both grain free) and it seems that the vomitting has stopped...but he still trails into the litterbox (he doesn't make it all the way to the box all the time). I have done every prescription diet for sensitive tummies under the sun and have don't long-term metronidazole and cobalamin-folate injections and nothing seems to help all that much.

Just curious...what are the pros and cons in humans?

My kitty has been on & off oral prednisone for asthma flare ups from feline herpes.. It helps a great deal. The side effects due include increased appetite and I think a higher risk for diabetes and possible liver damage. Right now what we do with rocky is when his asthma flares up he goes to the vet for a steriod shot.. Basically I think it has the same effect as prednisone. He usually ends up going every 6-8 weeks for probably the last year or so. He definitely has gained weight, but the side effects outweight the risks. I truly think he wouldn't make it without this drug. He has 3 little friends to keep him active and plenty of cat furniture to climb.
Oh, and I forgot that I've heard that the possiblity for side effects isn't as bad in cats as it is for dogs..

Originally Posted by lionessrampant

I've been wondering the same thing about Raphael....his weight has been up and down a whole lot and his stool goes from reasonably formed but still very soft to explosive and lquid. We switched him to Wellness Chx and are now doing a mix of that and Evanger's Turkey/Squash (both grain free) and it seems that the vomitting has stopped...but he still trails into the litterbox (he doesn't make it all the way to the box all the time). I have done every prescription diet for sensitive tummies under the sun and have don't long-term metronidazole and cobalamin-folate injections and nothing seems to help all that much.

Just curious...what are the pros and cons in humans?

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We tried Wellness with Teddy... out it came...
Unfortunately, Teddy has rarely had formed stool.

As for prednisolone in humans (and my major concern for Teddy) is that steroids lower the immune response, causing one to be more prone to infections and, when an infection is present, it's usually much harder to fight off. Other things include increased appetite, increased thirst, and with that, increased urination. In people, there are also vision problems that can be associated - but those are less common or rare.

For long term use, some of the side effects are similar to what you see with other medications... again, some of the vision stuff, vomiting, weight gain, headaches, etc. etc... there are a bunch, too many to list here (some are skin changes, weird places to have pain).

We're going to see how it goes, especially when we get down to the every-other-day stage. While I dislike the potential dependency on the drug... if it works, I'm not going to argue with it.

I always post this when someone has a cat with IBD. This was from another member and I am positive that it saved my cats life.

1. Remove ALL dry food from the diet.
2. Remove any food with grains. This is the most important...as no cat can process grains but it really, really kills the IBD kitties. The only kind of food my IBD cat can tolerate is Wellness Chicken. If you can and your kitty will go for it, consider trying a grain-free raw diet. Unfortunately, some kitties never adapt to it and there are a lot of circumstances that make this impossible for people to keep up with. Wellness is the only grain-free, by-product free food that I personally am aware of.
3. Use a lactose-free, hypoallergenic probiotic such as Power-dophilus, which can be purchased at vitamin stores in the food. About 4 billion live cells should do it for an average sized cat.
4. Have the cat's cobalamin levels tested. IBD cats are frequently not even on the chart. They'd do cobalamin injections, if my memory serves me correctly, once a week for 2 weeks, once ever other week for 2 months and then once a month as needed for maintenence.
5. Try to avoid the use of steroids to treat the issue. Pred will certainly alleviate symptoms, but will do very little to actually aid in the recovery of the cat's bodily systems.
6. If you are prescribed an anti-biotic by your vet it is IMPERATIVE that you use a probiotic the ENTIRE time the cat is on the a-biotic.


I didn't have to do step 4 but after 9 months of diarrhea it has been solved now for 3 months and I know longer have to use the probiotic, good luck.

Originally Posted by kulboy

I always post this when someone has a cat with IBD. This was from another member and I am positive that it saved my cats life.

1. Remove ALL dry food from the diet.
2. Remove any food with grains. This is the most important...as no cat can process grains but it really, really kills the IBD kitties. The only kind of food my IBD cat can tolerate is Wellness Chicken. If you can and your kitty will go for it, consider trying a grain-free raw diet. Unfortunately, some kitties never adapt to it and there are a lot of circumstances that make this impossible for people to keep up with. Wellness is the only grain-free, by-product free food that I personally am aware of.
3. Use a lactose-free, hypoallergenic probiotic such as Power-dophilus, which can be purchased at vitamin stores in the food. About 4 billion live cells should do it for an average sized cat.
4. Have the cat's cobalamin levels tested. IBD cats are frequently not even on the chart. They'd do cobalamin injections, if my memory serves me correctly, once a week for 2 weeks, once ever other week for 2 months and then once a month as needed for maintenence.
5. Try to avoid the use of steroids to treat the issue. Pred will certainly alleviate symptoms, but will do very little to actually aid in the recovery of the cat's bodily systems.
6. If you are prescribed an anti-biotic by your vet it is IMPERATIVE that you use a probiotic the ENTIRE time the cat is on the a-biotic.


I didn't have to do step 4 but after 9 months of diarrhea it has been solved now for 3 months and I know longer have to use the probiotic, good luck.

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Yeah, that was me

I'm glad to see you've had success....now if the rest of us could just find some!

Originally Posted by kulboy

I always post this when someone has a cat with IBD. This was from another member and I am positive that it saved my cats life.

1. Remove ALL dry food from the diet.
2. Remove any food with grains. This is the most important...as no cat can process grains but it really, really kills the IBD kitties. The only kind of food my IBD cat can tolerate is Wellness Chicken. If you can and your kitty will go for it, consider trying a grain-free raw diet. Unfortunately, some kitties never adapt to it and there are a lot of circumstances that make this impossible for people to keep up with. Wellness is the only grain-free, by-product free food that I personally am aware of.
3. Use a lactose-free, hypoallergenic probiotic such as Power-dophilus, which can be purchased at vitamin stores in the food. About 4 billion live cells should do it for an average sized cat.
4. Have the cat's cobalamin levels tested. IBD cats are frequently not even on the chart. They'd do cobalamin injections, if my memory serves me correctly, once a week for 2 weeks, once ever other week for 2 months and then once a month as needed for maintenence.
5. Try to avoid the use of steroids to treat the issue. Pred will certainly alleviate symptoms, but will do very little to actually aid in the recovery of the cat's bodily systems.
6. If you are prescribed an anti-biotic by your vet it is IMPERATIVE that you use a probiotic the ENTIRE time the cat is on the a-biotic.


I didn't have to do step 4 but after 9 months of diarrhea it has been solved now for 3 months and I know longer have to use the probiotic, good luck.

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Thank you for posting this... very interesting.
Unfortunately - and oddly as it may sound - Teddy has done the best on the Science Diet w/d dry. He has always had problems with canned food - it makes him worse.

We tried the Wellness route with Teddy... and he loved it, but it does not love him.

I appreciate the info. For Teddy, it's a matter of lots of trial and error, and picking and choosing. Things work for a few weeks to a few months, and then abruptly just stop. He did fantastically on IVD duck and pea dry (again, the canned made him sicker) until one day... he couldn't take it any more. I'm hesitant about trying raw for a host of reasons - particularly because anything else that has gone into Teddy's system (yogurt, rice, and even chicken) has come back out.

Ah, my special kitty...

IBD in cats is so frustrating!!!! There are risks with long term use of any steroid and you are right to be concerned about this. But IBD is all about trial and error, and if this becomes the one thing that helps him, then you have to weigh the risks against his life without it.

I have a cat who will be on a different steroid the rest of his life (auto-immune disease). Without it, he is in pain and suffering. We chose to risk the side effects based on his quality of life, knowing that he will have a shortened life. Sometimes you chose quality over quantity.

Keep up the trial and error. It may be that you can stabilize him with other drugs and can wean him off the pred. My heart goes out to you thru this frustrating disease!!

I have been told by two diffent vets with two very different philosophys that short term steriods is not bad ( ie Kandie got a shot that lasts for 4-6 weeks) but yes long term has many risks ....

I'm actually going to the vet tomorrow and plan to ask this there, but was wondering if anyone had an answer in the mean time -

Can prednisolone be crushed up and put in wet food? I know some drugs don't have the same effect when they're crushed. Has anyone tried this? Does it taste funny to cats, or do they eat it?

Thanks!

Long term use of prednisone can lead to some pretty serious health issues. It's a temporary method at best. Good luck at the vet's.

Thanks for all the well-wishes. Unfortunately, I think Teddy will need long term steroids, but we're hoping to wean him down to a low maintenance dose every other day. We're far from there yet (about 3 weeks to go)... and knowing Teddy, I don't think he'll be able to be without the medication, but we'll see. At least he's comfortable and acting like himself again, which I'm extremely thankful for.

My older cat was on and off Prednisone for over 2 years for her IBD
The main thing was that the side effects from the steroids were nowhere near as bad as the disease.
Used to wean her off them every few months- a few weeks later her vomiting would start again- and she would be miserable.
She also has a kidney problem- the dehydration from the vomiting was not good for that also.
I did a lot of fiddling with her diet- (raw mix and Royal Canin Sensible worked for her) She's been off all medication for 2 years now- much to my relief as I also worried about side effects.

Prednisone tastes vile-and important once it is started it is not stopped suddenly- so I prefered giving tablets- at least I knew she had taken it
Good luck and best wishes

Originally Posted by Bibby

My older cat was on and off Prednisone for over 2 years for her IBD
The main thing was that the side effects from the steroids were nowhere near as bad as the disease.
Used to wean her off them every few months- a few weeks later her vomiting would start again- and she would be miserable.
She also has a kidney problem- the dehydration from the vomiting was not good for that also.
I did a lot of fiddling with her diet- (raw mix and Royal Canin Sensible worked for her) She's been off all medication for 2 years now- much to my relief as I also worried about side effects.

Prednisone tastes vile-and important once it is started it is not stopped suddenly- so I prefered giving tablets- at least I knew she had taken it
Good luck and best wishes

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It's funny - the vet said it's fine to crush it, so I did, mixed it with Teddy's food, and he ate it all up!
So hopefully, it will work that way for me, at least for a little while.

We've just started dialing down the dose a bit - we'll see how low we can go...

Thanks.

My cat also has IBD and is 11 yrs old. He eats only dry food and will not eat ANY people food or wet food. I had the Vet make up Prednisolone as a transdermal and i just smear a little on the inside of his ear every other day. Works great!!  If you don't have a compounder or your Vet can't find one, just get a prescription from your Vet and use one of the on-line Vets like Foster & Smith. www.drsfostersmith.com

My experience with prednisolone was for allergies, but I assume the risks of long-term use are the same for IBD. When a vet told me steroids cause organ failure and diabetes, I agreed to order a blood test to determine exactly what Wilbur was allergic to. The customized shots were not purrfect, but they did not make him sneeze like the prednisolone did or carry the risk of killing him.

What this means to you is no matter how effective prednisolone is, if anything else works for your IBD cat, it should be avoided. A couple shots don't hurt, but because IBD is chronic, you are talking about a lifetime on the drug. I understand sometimes nothing else works, but I believe other methods should be tried first if any exist.

I'm not pro steroids but pro quality of life in IBD kitties and I've got case studies on my site showing that a lot of them have no choice but to stay on pred. They've tried being lowered and can't seem to function as well or feel as well. Many of them have been on low doses of pred for years and haven't had any problems. Not all kitties get diabetes and other side effects. There's another steroid called Entocort that does not have to be processed by the liver if you want to talk to your vet about that. I have case studies currently using that drug as well. I think for now take it a day at a time and just look at the difference in him as he was in bad shape before. I'm sure others here will mention trying a raw food diet and seeing if that works. Either way, I understand your trepidation. I'm just so glad your kitty is doing so much better right now. There's a lot of hope there now! 

Hello,

   I saw a post by finnlacey who said that "low doses" of pred in cats could be tolorated for years. What is meant by "low doses"? Also they mentioned to try other alternatives. Like what? Entocort was mentioned and I will look into that.

Thanks.