Experiences with dexamethasone steroid to treat IBD?

[dulcemir]

My senior kitty (15.5 years old) was diagnosed with IBD a year ago. Since then, he's been on budesonide for about 6-8 months, then on prednisolone for about a month. He hated the latter and would always spit most of it out or puke after taking it. Went back to the vet, and he prescribed my boy 0.15 ml dexamethasone to be injected subcutaneously.

First, I feel really bad doing the injections. I feel bad for possibly sacrificing the quality of life for my baby.

The vet said that 0.15 ml was a pretty high dose, and that, if this doesn't work, it might be the end of the options to treat this IBD, since we've gone through a few steroids by now.

Does anyone have experience with injectable dexmethasone? How did your kitty respond to the medication?

I'm on day 2 right now, and my cat puked up his breakfast this morning.

I'm pretty distressed about all of this, but I know what the reality is and just need to prepare myself for it.

 

[daftcat75]

There's often a dietary aspect to IBD. What is he eating? Have you tried an all wet food diet with simple single protein foods? Rawz is pretty much the gold standard for IBD kitties. I recommend the rabbit or rabbit with pumpkin recipe. They will send you samples if you write them. A few of their online resellers also sell by the can (and the case) making it easier to try the different flavors.

Subcutaneous injections are not that bad. Do them right and the cat doesn't even notice. There are many Youtube videos with demonstrations and tips for subQ injections. If the vet is telling you to stick him in the scruff of the neck, that's the same spot as kitty B-12 injections. You can simply search for those if you aren't getting any results for dexamethasone.

How's his weight? If he is losing weight despite a normal appetite, his IBD may have progressed to lymphoma. You might want to discuss chlorambucil (chemotherapy) if he isn't responding to steroids. A lot of cats actually tolerate chlorambucil better than prednisilone. But a lot of vets don't like prescribing chemo without a cancer diagnosis. Unfortunately, many cats who are suspected for lymphoma are poor candidates for getting that diagnosis via a surgical biopsy. Perhaps you can discuss trying chlorambucil if the steroids aren't working for him.

By the way, just about any medicine can be compounded to make it more appealing to the cat (flavored liquids besides cherry flavor) or easier to give (like transdermal.) Wedgewood Pharmacy is my favorite online pharmacy for compounding pet medications. Your vet will call or fax in the prescription. Then you can speak with a customer support rep or directly with a pharmacist if they can't answer your questions to decide on a formulation that works with your cat. Discuss with your vet whether the dexamethasone has to be injected subcutaneously when there are other preparations also available. It may be that the injectable is all that your vet has available.

Dexamethasone Oral Suspension

 

[Catmom1234567890]

Is rabbit easily digestible

 

[daftcat75]

Is rabbit easily digestible

Yes. It's closer to mouse than chicken or fish. Though I mention and recommend rabbit in terms of it being a novel protein. However, meat will always be more digestible than non-meat (veggies, grains, starches, plant proteins, etc) for strict meat-eating animals (obligate carnivores) like cats.

 

[dulcemir]

There's often a dietary aspect to IBD. What is he eating? Have you tried an all wet food diet with simple single protein foods? Rawz is pretty much the gold standard for IBD kitties. I recommend the rabbit or rabbit with pumpkin recipe. They will send you samples if you write them. A few of their online resellers also sell by the can (and the case) making it easier to try the different flavors.

Subcutaneous injections are not that bad. Do them right and the cat doesn't even notice. There are many Youtube videos with demonstrations and tips for subQ injections. If the vet is telling you to stick him in the scruff of the neck, that's the same spot as kitty B-12 injections. You can simply search for those if you aren't getting any results for dexamethasone.

How's his weight? If he is losing weight despite a normal appetite, his IBD may have progressed to lymphoma. You might want to discuss chlorambucil (chemotherapy) if he isn't responding to steroids. A lot of cats actually tolerate chlorambucil better than prednisilone. But a lot of vets don't like prescribing chemo without a cancer diagnosis. Unfortunately, many cats who are suspected for lymphoma are poor candidates for getting that diagnosis via a surgical biopsy. Perhaps you can discuss trying chlorambucil if the steroids aren't working for him.

By the way, just about any medicine can be compounded to make it more appealing to the cat (flavored liquids besides cherry flavor) or easier to give (like transdermal.) Wedgewood Pharmacy is my favorite online pharmacy for compounding pet medications. Your vet will call or fax in the prescription. Then you can speak with a customer support rep or directly with a pharmacist if they can't answer your questions to decide on a formulation that works with your cat. Discuss with your vet whether the dexamethasone has to be injected subcutaneously when there are other preparations also available. It may be that the injectable is all that your vet has available.

Dexamethasone Oral Suspension

Thanks for your quick reply. I was following Krista’s story for a while and am getting emotional thinking about it. Cats are gifts.

I’ve tried all kinds of proteins. He did really well when he was first diagnosed. He ate Natural Instinct limited ingredient dry rabbit food and was taking 1 ml of budesonide a day. He kept up for about 6-8 months, then wasn’t eating it anymore.

I went back to wet food—Natural Instinct wet turkey. He likes it enough to eat it, but he doesn’t even go through a can a day.

Based on your recommendation, I went out to the specialty pet store about a mile from my house, and lo and behold, they carried Rawz wet rabbit food. The person at the counter also recommended Koha wet rabbit and Vital Essentials raw rabbit food, which I bought. $50 for a small bag of that + 4 cans of the wet food, ha.

My cat has lost weight since his last vet appointment in late July. Back then, he was 9 pounds. Today, he’s 8.36. The weight loss is all because of his lack of appetite.

I think the vet suspects the prednisilone is not longer being absorbed because of the inflammation in his intestines, so he wanted to try this subcutaneous steroid in the meantime.

 

[fionasmom]

IBDKitties – Helping Save Lives…One Paw at a Time

This is a very complete site which deal with IBD and you will find dexamethasone covered, along with most other topics related to IBD.

Just want to add that doing injections is not bad, definitely something you can learn to do. I have learned to do every type for my pets frankly it is easier than putting a pill down the throat of a resistant dog or cat. Wedgewood is the best if you want to compound and they will really try to help you, even before you purchase from them.

 

[daftcat75]

I like that Vital Essentials. Hopefully your guy will too.

Is he taking anything for the nausea? Cerenia or Zofran?

Hopefully the dexamethasone helps.

He probably does have dietary triggers that you still need to get to the bottom of. If he will eat the Vital Essentials rehydrated--or crumbled on top of or mixed into the Rawz if he doesn't like it rehydrated--that's about the closest to ideal recipes that I could recommend. You aren't going to do much better even if you went homemade. Trust me! I did do homemade rabbit for awhile. Very expensive!

How long does the vet want to try the dexamethasone for? Perhaps you can discuss chlorambucil (chemotherapy) with the vet if steroids aren't working. It will certainly be less risk to try the drug than to perform the biopsy to confirm lymphoma first.

 

[dulcemir]

He's eating the Vital Essentials! Yay. The rabbit smells like something else. I don't know how cats find it palatable, ha!

The vet prescribed me Cerenia, but recommended I only use it when he is in one of his vomiting spells. I only give him 1/4 tablet at a time.

The vet didn't say anything about how long he wanted me to administer dexamethasone. I will broach the topic of chlorambucil with him should it ever come up (I really hope it doesn't). I don't think I'll entertain a biopsy because it's just so invasive, and my cat is quite old at this point. My top priority at the moment is calming the inflammation in his intestines, then, if I can't, pain management.

 

[daftcat75]

He's eating the Vital Essentials! Yay. The rabbit smells like something else. I don't know how cats find it palatable, ha!

The vet prescribed me Cerenia, but recommended I only use it when he is in one of his vomiting spells. I only give him 1/4 tablet at a time.

The vet didn't say anything about how long he wanted me to administer dexamethasone. I will broach the topic of chlorambucil with him should it ever come up (I really hope it doesn't). I don't think I'll entertain a biopsy because it's just so invasive, and my cat is quite old at this point. My top priority at the moment is calming the inflammation in his intestines, then, if I can't, pain management.

Is he eating the Vital Essentials rehydrated? That food has ground bone in it which could make him constipated. Rehydrating it or mixing it with wet food should lessen that.

I used to make raw food from whole fryer rabbits for Krista. We couldn’t find a commercial raw that agreed with her that she liked since Rad Cat had been shut down. Yes. Those rabbits smell something ripe. Stinky chickens is what I used to call them. Without the bunny features, they look like chicken. But smell like something entirely different.

Eating healthily and not having gut or butt incidents is goal number one. Weight management or weight gain is the next thing. You can get a baby scale off Amazon for about $50. Just leave it out in his environment and let him get used to seeing it. Find some freeze dried rabbit meat treats (I think Vital Essentials makes those too.) When you’re doing a novel protein, you always want to pair treat protein with food protein or the treats undermine the food effort. Use treats to lure him on the scale and keep him busy for a couple seconds to get a reading. Weigh him no more than once a week, preferably the same time each week. If his weight is stable, you can weigh him once a month until it’s not. But if he continues to lose weight, despite eating well, that’s when you talk to your vet about chlorambucil. As long as he is maintaining or can regain weight, it’s probably not lymphoma.

 

[daftcat75]

Feb 1, 2020:
Krista wanting to inspect the smelly chicken. But she’s being held back by an inch of water at the bottom of that litter box in front of her. She doesn’t feel like wading for wabbit.