How Long Does Prednisolone Take to Reduce Inflammation on cats with IBS and Increase Appetite?

[Shrimp's Mom]

My cat possibly has IBS (We cannot afford to do a biopsy and given her symptoms the vet has prescribed prednisolone, 5 mg a day). My question is, how long does the medication (pill) take to work in terms of reducing her inflammation? More importantly, I hear that one side effect is increased appetite and I want to know how long that takes to take effect? She is eating but given her weight loss I want her to gain weight. I have read prednisolone can take a couple of weeks to work and some other places online say a couple of hours so I am confused. I really want her to start gaining weight and wonder if this is enough and i just need to wait or if she may need something like mirtazapine in conjunction.

Also, if cats with IBS have a hard time absorbing things, then how can she absorb the prednisolone pill? Would the liquid be better? Or is prednisolone absorbed in the stomach as opposed to intestine where the inflammation possibly is, so it wouldn't matter.

 

[Alldara]

It worked fast for Magnus but didn't really make him more hungry. You'll want her to gain slowly anyways so just a little extra food at a time is best. Gaining weight too fast can cause problems too.

You can get a few cans of Royal Canin recovery for your cat to help start her off.

For Magnus we also fed him Royal Canin Mother and Babycat for awhile because it's easier to digest.

We found his was caused by a food allergy to beef and beef by-products.

 

[Margot Lane]

Didn’t take more than a week of pred w/ Zorro for the appetite to kick in— with him it‘s been a chicken allergy and we did do the biopsy. Praise be he’s now in remission going on 2 years. There are a lot of really excellent threads on IBS on this website. Some people swear by mirtz but I haven’t had the need to try it yet. As far as affordability, there are also really good threads on TCS about pet health insurance, which can save you $ down the road (don’t know if you‘ve explored that option).

 

[Alldara]

As far as affordability, there are also really good threads on TCS about pet health insurance, which can save you $ down the road (don’t know if you‘ve explored that option).

Just a heads up about pet insurance. Your pet has a preexisting condition now. Your insurance will not cover anything IBS related.

With some good insurances, if he has no symptoms for a year, it will become covered. But getting insurance now will not help you get that biopsy.

I didn't do biopsy. We started with an allergy diet.

 

[Shrimp's Mom]

Thank you. I really do not see the point of biopsy. First of all, it is invasive having the doctor go do bowel surgery on a cat that's lost weight etc. Second, let's say it turns out to be lymphoma, I am not going to put a cat through chemo or any of that stuff. That would be cruel and inhumane and will likely do more damage than not. I had a cat once who got radiation for oral cancer and it ate away half his face. He died from the radiation, not the cancer. Never again.

Thing is, there is no cure for cancer. And I am not going to put myself into thousands of dollars in debt and torture my cat in the process for what....12-18 more months tops, most of which she will have a diminished quality of life due to the poisons in her chemo and radiation. That is not an option. Plus isn't prednisolone already considered a chemo drug of sorts?

Didn’t take more than a week of pred w/ Zorro for the appetite to kick in— with him it‘s been a chicken allergy and we did do the biopsy. Praise be he’s now in remission going on 2 years. There are a lot of really excellent threads on IBS on this website. Some people swear by mirtz but I haven’t had the need to try it yet. As far as affordability, there are also really good threads on TCS about pet health insurance, which can save you $ down the road (don’t know if you‘ve explored that option).

 

[daftcat75]

Thank you. I really do not see the point of biopsy. First of all, it is invasive having the doctor go do bowel surgery on a cat that's lost weight etc. Second, let's say it turns out to be lymphoma, I am not going to put a cat through chemo or any of that stuff. That would be cruel and inhumane and will likely do more damage than not. I had a cat once who got radiation for oral cancer and it ate away half his face. He died from the radiation, not the cancer. Never again.

Thing is, there is no cure for cancer. And I am not going to put myself into thousands of dollars in debt and torture my cat in the process for what....12-18 more months tops, most of which she will have a diminished quality of life due to the poisons in her chemo and radiation. That is not an option. Plus isn't prednisolone already considered a chemo drug of sorts?

Oral cancer is an aggressive one with poor prognosis. Your vet never should have allowed you to spend money on that.

There are a couple of kinds of intestinal lymphoma: small cell and large cell. Large cell lymphoma forms masses (tumors) and can metastasize. Poor prognosis. Small cell lymphoma is a diffuse inflammation that is indistinguishable from IBD in an ultrasound and hence a biopsy is the only way to know for sure. I believe you made the correct choice not to put an unstable cat through a surgery. However, small cell lymphoma can have good outcomes. It can't be cured. But it can be put into remission with high quality of life.

Chlorambucil is the chemo drug for small cell lymphoma and it is generally tolerated very well. My last cat Krista had her IBD progress into lymphoma. I had to fight my vet and even go over her head to the owner and founder of the practice to get the chemo prescription because she was pushing for a biopsy and I was arguing that that would set Krista back further. On the call with the owner/founder, I told him the diagnosis carries more risk than the drug. We can't keep giving pred because it isn't doing enough and we can't do nothing. He agreed with me and we got her on the chlorambucil as quickly as it took to have it compounded. I was not going to wrestle Krista to get that into her. Her symptoms were liquid poop and rapid weight loss. Even with the pred, the poop maybe only became soft serve and while her appetite was ravenous, she was still losing weight. Within one dose of the chemo (something that can be compounded and given at home), her poop firmed up. We were doing weekly weigh-ins at home with a baby scale. That week, her weight loss finally stopped. Sadly, her remission was incomplete because at the same time that I started her on chemo, I took away her raw food treat portion that was helping ease our nightly pred wrestling matches. Instead, I wrapped her pred pill in fish flakes which was a trigger food of hers. It wasn't until I finally switched her pred to transdermal and skipped the fish flakes that she finally achieved remission. She was having perfect poops, no vomiting episodes. Tragically, she developed a urinary tract infection the next month that proved too much for her having been on steroids and chemo for so long.

But the real point I'm trying to make here is that lymphoma doesn't mean you have to put her down. Chemo can really benefit cats without a hit to their quality of life. Chlorambucil is well tolerated by most cats with few and mild symptoms if any. Sometimes it is used in place of prednisilone because it actually has fewer and less severe long-term side effects. In Krista, the only noticeable side effect from chemo was that she was a little more lethargic on dosing days. I didn't see a dip in appetite or anything else that would suggest she was truly miserable, low quality of life, or anything that might be ascribed to the human experience of chemo.

If your cat has had an ultrasound and you were told it could be IBD or it could be small cell lymphoma (in other words, large cell lymphoma was ruled out), my recommendation would be to discuss an A/B treatment plan with your vet. Determine an appropriate length of time for the steroids ("A" plan) to show an improvement. And if after that interval, she's still losing weight and/or still symptomatic (butt or gut episodes), then you agree to move on to plan "B": add in the chlorambucil.

If you wanted to create a different thread about chemo and cats, I'm sure you'll get more than a few responses about guardians who have cats in remission for one, two, or more years.


*The other point hidden in there is that if you haven't figured out your cat's dietary intolerances yet, pred and chemo alone won't help her out if you are still feeding her inflammation triggers. Maybe while you are waiting for pred to do its thing, you can also try a wet-food-only novel protein (preferably grain-free) food. Rawz and Mouser both make fantastic foods for this purpose. Expensive. But worth it if it puts out the fire.

I would avoid the chicken one. But that leaves you three other flavors:
Search: 10 results found for "mouser" - Incredible Pets

Incredible Pets sells by the can so you don't have to buy a whole case to figure out which flavors your kitty may enjoy.

 

[Shrimp's Mom]

So if a cat with IBS has a hard time absorbing things, then how can the prednisolone pill be absorbed? We have had her on it for 2 days and she has liquid diarrhea again and vomiting. We only switched her to prednisolone because we thought it might help her with her appetite since with budesonide she was on she still occasionally was having loose stools and bile throw up in the middle of the night. But barely. But since she has been on prednisolone for just 2 days, things have gotten worse (also, we just today started her or Mirataz and she ate a lot of food, but then had liquid diarrhea and vomiting). What is going on? I thought prednisolone is this amazing drug that will definitely help her. Seems like she is getting worse with it. Or maybe is it not being absorbed? IS the transdermal version a better option?

 

[Shrimp's Mom]

Is the transgermal gel a better method than the pill in terms of better rate of absorption? Does anyone have this experience with their IBS cats?

 

[daftcat75]

Absorption is better through the oral route. And while transdermal may seem initially easier, keep in mind that you have to alternate ears and wash off the prior days dose on the off-day ear or you’ll reduce absorption of the next dose. So there’s a lot more ear handling than many cats would prefer. But some are just terrors to pill. it’s better to get suboptimal absorption through the ears than non-compliance with the oral route.

You can also get pred compounded to flavored oils or chews or possibly other forms too. I would say the best form is the one that you can regularly get into your cat. Oral absorption rate doesn’t matter if you can’t get it in her that way.

Have a look at Wedgewood to see the available compounding forms and flavors. I believe they can send you non-medicated blanks if you wanted to test different flavors with your cat before compounding her medicine. Their customer service is excellent. I would call them about that if you’re uncertain about which flavor to choose—if you’re going with a flavored option.
Prednisolone for dogs and cats: Uses, Dosage & Side Effects

 

[FeebysOwner]

Budesonide is more focused on the digestive tract than Prednisolone, so while every cat can have different outcomes on various medicines, it seems surprising to me that Pred would work any better than Budesonide for IBS. Budesonide also appears to have less impacts when used long term regarding the development of diabetes and heart issues than Pred.

Bile vomiting is often caused by a cat going too long without eating, so maybe her meals are spread too far apart on those occasions? I believe IBS cats do better with smaller more frequent meals.

As far as absorption goes, a lot of cats with IBS also are given B-12 injections to help with intestinal absorption. You can have a cobalamin test done to check your cat's B-12 level, or just ask the vet about prescribing B-12 shots (which you can easily do at home), as whatever B-12 that isn't used by the body is merely excreted through urination, so no 'overdose' is possible.

Transdermal meds are generally considered to be less effective compared to oral meds, as they are actually absorbed more poorly. Again, this can vary by cat, but I don't think getting a transdermal form of Pred is going to resolve this issue.

Also, some IBS cats will benefit from probiotics, and one that is often suggested for IBS (and many other situations) is s. boulardii - which can also help with loose stools and diarrhea.
The benefits of using S. Boulardii for cats– FullBucket Health

 

[Shrimp's Mom]

Thank you so much for this information. I really appreciate it.

She always vomits in the middle of the night, either just bile or vomit that contains a lot of liquid but contains no food since I think she just may have drank water. Ever since we stopped the liquid Budenoside and given her Pred, both her diarrhea and vomiting (the latter only once at night) came back, which is why I thought maybe the pred is not being properly absorbed.

We just gave her her first B-12 shot last week at 0.25 ml and are supposed to do it weekly. The reason I asked for pred to be given transdermal is because I remembered the reason the vet did not want to give her B-12 as a pill or liquid is precisely because she would not absorb the B-12 if ingested. The mirataz is given transdermal and seems to be working.

I wonder if she should just go back on the Budenoside since despite supposedly being stronger, Pred does not seem to work (or maybe it is not properly absorbed). The only reason we even switched her to Pred is cause of the nausea and poor appetite, which mirataz is taking care of. But if Budenoside had addressed the underlying issue in the first place, she would have no more nausea, right? I dont know if I just need to wait a bit more with Pred or switch her back to Bud. We tried probiotics and they did absolutely nothing , at least not by themselves. The only thing that worked like a miracle drug for diarrhea is mitronidazole.

Budesonide is more focused on the digestive tract than Prednisolone, so while every cat can have different outcomes on various medicines, it seems surprising to me that Pred would work any better than Budesonide for IBS. Budesonide also appears to have less impacts when used long term regarding the development of diabetes and heart issues than Pred.

Bile vomiting is often caused by a cat going too long without eating, so maybe her meals are spread too far apart on those occasions? I believe IBS cats do better with smaller more frequent meals.

As far as absorption goes, a lot of cats with IBS also are given B-12 injections to help with intestinal absorption. You can have a cobalamin test done to check your cat's B-12 level, or just ask the vet about prescribing B-12 shots (which you can easily do at home), as whatever B-12 that isn't used by the body is merely excreted through urination, so no 'overdose' is possible.

Transdermal meds are generally considered to be less effective compared to oral meds, as they are actually absorbed more poorly. Again, this can vary by cat, but I don't think getting a transdermal form of Pred is going to resolve this issue.

Also, some IBS cats will benefit from probiotics, and one that is often suggested for IBS (and many other situations) is s. boulardii - which can also help with loose stools and diarrhea.
The benefits of using S. Boulardii for cats– FullBucket Health

 

[Shrimp's Mom]

Thanks. It is not that I have a hard time giving her the pill. Well, I do, but it is not impossible and she does swallow. my problem is that what she swallows may not be absorbed since her vomiting (bile at night only) and diarrhea came back 3 days in Pred instead of going away. It almost seems like the Budenoside that was coating her intestines was working better at keeping the diarrhea and vomiting at bay. I am thinking she is not absorbing anything in pill form. Could that be?

Do you think the liquid compounded version of Pred may be easier absorbed than a pill?
Thank you again...

Absorption is better through the oral route. And while transdermal may seem initially easier, keep in mind that you have to alternate ears and wash off the prior days dose on the off-day ear or you’ll reduce absorption of the next dose. So there’s a lot more ear handling than many cats would prefer. But some are just terrors to pill. it’s better to get suboptimal absorption through the ears than non-compliance with the oral route.

You can also get pred compounded to flavored oils or chews or possibly other forms too. I would say the best form is the one that you can regularly get into your cat. Oral absorption rate doesn’t matter if you can’t get it in her that way.

Have a look at Wedgewood to see the available compounding forms and flavors. I believe they can send you non-medicated blanks if you wanted to test different flavors with your cat before compounding her medicine. Their customer service is excellent. I would call them about that if you’re uncertain about which flavor to choose—if you’re going with a flavored option.
Prednisolone for dogs and cats: Uses, Dosage & Side Effects

 

[daftcat75]

Liquid pukes in the middle of the night with no food in them sounds like she just needs an overnight portion. If it was a dietary insensitivity, you would see the food coming back up in some intermediate stage of digestion. If it comes back up shortly after eating and looks largely the way it went in, that's a regurgitation. It's helpful to know your cat barfs because there's different strategies for each.

For a liquid barf with no food, maybe bile, or probably just water and stomach acid (foamy), she likely needs an overnight meal. For many cats, dinner to breakfast is just too long to go without eating. I would look into a timed feeder and putting a wet portion in there. Dry food is really no good for these gut diseases.
Amazon.com

B-12 has to be given by injection because it often doesn't absorb well in an inflamed gut. But also because B-12 is required for B-12 absorption. Chicken and egg. If your girl is deficient to begin with, and most with intestinal diseases are, then injection is the better option.

Pred should work via the oral route. This is the standard. It may be that it takes a few more days. But it could very well be that pred is not the right drug here. Pred made Krista's liquid stools into something firmer. But her poops didn't really firm up until we also added the chemo drug, chlorambucil. That's why I encourage you to have that A/B treatment plan discussion with your vet. Tell him that surgery and biopsy are off the table. So your options are: back to budesonide, pred and pray (which is usually their default), do nothing (clearly not the right answer), or try the chemo drug. If they are truly concerned about prescribing chemo without a cancer diagnosis, have them discuss the risks of the biopsy surgery vs the risks of taking chemo without cancer. I think any honest doc should be able to tell you that, while they are uncomfortable giving a drug without a diagnosis, the diagnosis (the surgery) probably carries more risk than the drug.

If budesonide was working, they have anti-nausea medicines. Budesonide has fewer side effects and long-term risks than pred. But any medicine can make a cat nauseated even if it's good for them. Discuss the pred progress or lack thereof with your vet and determine whether switching to budesonide and adding in ondansetron (Zofran) might be a better course.

But realize that you might be dealing with lymphoma and you may not achieve better outcomes without chemo. So have that discussion too. Because if this is lymphoma, she'll likely continue to lose weight even with all the other treatments. Perhaps you should discuss this as a line in the sand: "if she goes below this weight, let's agree to try chlorambucil."

While you can weigh her by subtracting your weight from your combined weight while holding her, a baby scale is going to be more accurate. Once a week on Sunday mornings (I don't recommend more frequently than that for everyone's sanity), I put that baby scale on the kitchen floor, put a towel in the basket so it isn't quite such a hard surface, and I put treats on it. Betty knows the routine by now. She gets treats in exchange for a brief moment of having the rest of her lifted onto the platform (usually her butt.)

https://www.amazon.com/dp/B00QHK99CC/?tag=thecatsite

 

[FeebysOwner]

I don't think you can compare the analogy of the oral B-12 vs. injectable B-12 and the absorption of either to oral steroids vs. transdermal and the associated absorption with either. Kind of like comparing apples to oranges, as the old saying goes. How B-12 vs. how steroids are processed by the body has a good deal to do with how they are absorbed. And tbh, Budesonide is going to be absorbed similarly to Pred, but more specifically focused on the digestive tract as opposed to other parts of the body as is the case with Pred. It is just that one or the other of these steroids can be more or less effective based on each individual cat. I can't answer whether or not Pred would be considered to be more effective for vomiting, but if the IBS is what is causing it, I cannot see how Budesonide would be any less effective. I am not sure either steroid is a guarantee to completely stop vomiting. Even with proper management, symptoms can still come and go and may or may not require medication adjustments.

There actually are injectable steroids, so I guess you could ask about those, how they work, how often they would need to be given, etc.

It is pretty common for either Metro and/or S. boulardii to be given to cats with IBS. S. bouldardii is a more 'holistic' approach, because all it is doing is trying to balance gut bacteria to healthier levels. I wouldn't guess that it alone with no other meds/aids, however, would be the sole answer.

 

[daftcat75]

Thanks. It is not that I have a hard time giving her the pill. Well, I do, but it is not impossible and she does swallow. my problem is that what she swallows may not be absorbed since her vomiting (bile at night only) and diarrhea came back 3 days in Pred instead of going away. It almost seems like the Budenoside that was coating her intestines was working better at keeping the diarrhea and vomiting at bay. I am thinking she is not absorbing anything in pill form. Could that be?

Do you think the liquid compounded version of Pred may be easier absorbed than a pill?
Thank you again...

As intimated in the other thread, it’s likely not an absorption issue. B-12, pred, budesonide, and mirtazapine are all different drugs with different pharmacokinetics (fancy word for the way they are absorbed, metabolized, and excreted.)

Additionally, some medicines work better than others with some cats and some conditions. I think if budesonide was working, you may simply need to add an an anti-nausea and an overnight portion.

But you may also need to discuss the possibility of lymphoma and that these treatments may remain incomplete until chemo is added. I’m not pushing you towards chemo. I just want you to keep that on the table, have that discussion with your vet, and discuss when to entertain that as a treatment. Because she only has so much weight she can lose even if you stabilize everything else. And I’m fairly certain that if Krista had a little more weight, she wouldn’t have run out of lives when she got the UTI.

 

[Alldara]

There's research to show that probiotics alongside steroids can have a beneficial effect on the gut bacteria when treating chronic digestive issues.

However, I'd agree that probiotics on their own were never as likely to have the same effects.

Further, probiotics are a long term treatment and effects are not usually seen short term. Usually, it's necessary to use them for at least 1 or 2 months from what I was told.


Magnus will to this day, vomit bile at exactly 5:30 am if food is not left out overnight for him. Even if his last feeding was at midnight. His system needs food at that time.

 

[daftcat75]

There's research to show that probiotics alongside steroids can have a beneficial effect on the gut bacteria when treating chronic digestive issues.

However, I'd agree that probiotics on their own were never as likely to have the same effects.

Further, probiotics are a long term treatment and effects are not usually seen short term. Usually, it's necessary to use them for at least 1 or 2 months from what I was told.


Magnus will to this day, vomit bile at exactly 5:30 am if food is not left out overnight for him. Even if his last feeding was at midnight. His system needs food at that time.

Maybe that's why I stopped fighting it and I have a 4:45am alarm to get up and feed and give Betty her morning meds. Then we both climb back into bed for what I call "third sleep." (One or both of us usually wake up in the middle of the night and then come back to bed for second sleep after bathroom business.) As much as I'd like her to be a 6 and 6 or 7 and 7 schedule, 5 and 5 tracks more with her natural cycles. Thank goodness I'm still WFH!

Probiotics are helpful when you find the right ones. But they're not going to be strong enough on their own. Most don't even have enough colony forming units to move the needle, so to speak. S boulardii is an exception. It doesn't form colonies. But due to its similar structure to the gut wall, it has both soothing effects on the gut wall as well as protective effects against many pathogenic strains. Those strains that attach to and scavenge dead epithelial cells will attach to the decoy gut (s. boulardii cells) instead and get flushed out with her poop. For this reason, and especially for any cat that has gone through a cycle of metronidazole, I recommend twice daily administration of s. boulardii. Hopefully she likes the taste like Krista did and you can mix it into her food. But if she doesn't like the taste, like my current cat, Betty, you can repack them into gelatin capsules. The Jarrow brand comes in gigantic size 00 (smaller number means bigger) capsule size. My Betty will take size threes on her own but if you are going to pill her yourself, I recommend size four capsules. You can get a size four capsule filling machine off Etsy for about $30. Search for the seller MYHERBAR since the last time I tried to post the link here, the redirects wouldn't resolve.

This is the brand of s. boulardii I recommend:
Amazon.com

There are couple different kinds of s. boulardii. Well, the s. boulardii is always the same. But the adjunct sugar it comes with can be MOS or FOS. I prefer MOS. I have seen better results with Betty with MOS over FOS. What's the difference? Without getting overly technical (because honestly I forgot the technical details), MOS acts more like s. boulardii itself in that it also binds pathogenic bacteria to be excreted. While FOS is supposed to feed beneficial strains of bacteria. I think of them like this. MOS is scrubbing bubbles for pathogenic bacteria. FOS is lunch boxes for beneficial bacteria. But most IBS/IBD cats don't even have those beneficial strains anymore. Lots of lunch boxes going unclaimed. I'm told it's better to weed the garden before planting new roses. (I wouldn't know. I have a postage stamp of "garden" space in my apartment.)

 

[Shrimp's Mom]

Thank you so much for taking the time to explain this to me. I really appreciate it.

I do have the exact same baby scale as you and I use it (probably too frequently) to weigh her. I always feel sick to my stomach like my heart just drops if i see her lose even a few ounces. Like I said with the mirataz she has been eating more (and even before she had appetite and kept begging for food but would be very picky). But she is less picky now and consumes larger volumes of food. Now let's see if she keeps losing weight.

Are you saying the nausea could be from the meds as opposed to from her IBS or possibly lymphoma?

She is due for her second B-12 shot this week and we just called the vet and he is prescribing the compounded liquid form of Pred for better absorption. As someone said on here the dermal version is not the best for this one.

How long does lymphoma take to develop? I know that sometimes IBS can lead to lymphoma, but how long would a cat have to have had IBS before it becomes lymphoma? Years? Months? Weeks? We noticed the weight loss with her in March where we just randomly put her on the scale on noticed that just last July she weighed 13.9 lbs and now was weighting 12. This is what started this whole thing. No other symptoms. I know cats are good at hiding their symptoms and we are almost paranoid about even the slightest behavioral change but with her it almost seemed from overnight to eating well and firm poops to going to vet for blood work and bam the next day she had liquid diarrhea and vomiting almost every night (at first fur balls then just bile). Only metronidazole stopped it.

So I am really perplexed how this could be and how long she may have had either. All her bloodwork was in the excellent range. She had surgery 6 weeks ago due to a benign cysts on her back and one on her foot ( not invasive open up the bowels surgery) and it lasted only 30 minutes. I thought she maybe lost a bit of weight cause of that. They did lab work before her surgery and everything was good then too.

I will consider the chemo. I just remember what it did to my mom and I would not do that to a voiceless, innocent cat. I really don't want to hurt her or make her suffer, which is why biopsy is out of the question. But it is reassuring that the chemo you cited is not like human chemo.

Liquid pukes in the middle of the night with no food in them sounds like she just needs an overnight portion. If it was a dietary insensitivity, you would see the food coming back up in some intermediate stage of digestion. If it comes back up shortly after eating and looks largely the way it went in, that's a regurgitation. It's helpful to know your cat barfs because there's different strategies for each.

For a liquid barf with no food, maybe bile, or probably just water and stomach acid (foamy), she likely needs an overnight meal. For many cats, dinner to breakfast is just too long to go without eating. I would look into a timed feeder and putting a wet portion in there. Dry food is really no good for these gut diseases.
Amazon.com

B-12 has to be given by injection because it often doesn't absorb well in an inflamed gut. But also because B-12 is required for B-12 absorption. Chicken and egg. If your girl is deficient to begin with, and most with intestinal diseases are, then injection is the better option.

Pred should work via the oral route. This is the standard. It may be that it takes a few more days. But it could very well be that pred is not the right drug here. Pred made Krista's liquid stools into something firmer. But her poops didn't really firm up until we also added the chemo drug, chlorambucil. That's why I encourage you to have that A/B treatment plan discussion with your vet. Tell him that surgery and biopsy are off the table. So your options are: back to budesonide, pred and pray (which is usually their default), do nothing (clearly not the right answer), or try the chemo drug. If they are truly concerned about prescribing chemo without a cancer diagnosis, have them discuss the risks of the biopsy surgery vs the risks of taking chemo without cancer. I think any honest doc should be able to tell you that, while they are uncomfortable giving a drug without a diagnosis, the diagnosis (the surgery) probably carries more risk than the drug.

If budesonide was working, they have anti-nausea medicines. Budesonide has fewer side effects and long-term risks than pred. But any medicine can make a cat nauseated even if it's good for them. Discuss the pred progress or lack thereof with your vet and determine whether switching to budesonide and adding in ondansetron (Zofran) might be a better course.

But realize that you might be dealing with lymphoma and you may not achieve better outcomes without chemo. So have that discussion too. Because if this is lymphoma, she'll likely continue to lose weight even with all the other treatments. Perhaps you should discuss this as a line in the sand: "if she goes below this weight, let's agree to try chlorambucil."

While you can weigh her by subtracting your weight from your combined weight while holding her, a baby scale is going to be more accurate. Once a week on Sunday mornings (I don't recommend more frequently than that for everyone's sanity), I put that baby scale on the kitchen floor, put a towel in the basket so it isn't quite such a hard surface, and I put treats on it. Betty knows the routine by now. She gets treats in exchange for a brief moment of having the rest of her lifted onto the platform (usually her butt.)
View attachment 452839
Amazon.com

 

[Shrimp's Mom]

Yes. It is almost like clock work with the vomiting. Really strange...

I started giving her

Nutramax Proviable Digestive Health

then switched over to

Dr Formulas Nexabiotic Probiotics for Cats Powder | Treats Diarrhea for Pets with Saccharomyces Boulardii Lactobacillus Acidophilus (--> cause it has more strains and s boulardii)

Then i was looking at

Clearmax Probiotics for cats and dogs which is a liquid form

But I guess I did not do it long enough and now am confused which is the best. Can you combine probiotics like give nutramax one day and Dr. Formulas the next or is that not recommended?

I also tried Smalls raw food and she loved it at first, then she got bored with it (which is typical for both my cats. They are picky eaters that want different flavors and consistencies all the time and they been like this their whole lives).

There's research to show that probiotics alongside steroids can have a beneficial effect on the gut bacteria when treating chronic digestive issues.

However, I'd agree that probiotics on their own were never as likely to have the same effects.

Further, probiotics are a long term treatment and effects are not usually seen short term. Usually, it's necessary to use them for at least 1 or 2 months from what I was told.


Magnus will to this day, vomit bile at exactly 5:30 am if food is not left out overnight for him. Even if his last feeding was at midnight. His system needs food at that time.

 

[daftcat75]

That vomiting on schedule and the composition of the vomit sounds a lot like she needs an extra portion. I don't think meds will fix that. But there's clearly something behind the diarrhea and the weight loss. That's something you need to take in a notebook and have a discussion with your vet. Set up an A/B plan or an A/B/C plan if you want to trial pred (A), possibly return to budesonide (B), or maybe even bring in the chemo (C.) But it's really easy to get hopeful and stubborn that this next thing, this probiotic, that tummy supplement, just one more thing I want to try before... No! Have a discussion with the vet and set some mile markers and next steps if she's not responding to the current plan. Lymphoma is rapid and relentless weight loss. It doesn't sound like you're there yet. But weigh her weekly (no more than weekly) and decide, with your vet's input, the line in the sand where her weight loss is unacceptable and you need to try the big guns of chemo. Generally, if she can maintain or even gain weight, it's probably not lymphoma (yet.)

I don't think most probiotics are worth their cost. They are frequently too few strains and too few colony forming units. That said, Proviable is probably better than nothing. At least that's vet approved. But I think s. boulardii is probably going to be more beneficial than guessing which bacterial probiotics might help.

Yes, any medicine has the potential to cause nausea or upset stomach despite working towards managing the condition. Ondansetron is a safe medicine that can be added to the protocol relatively easily.

If your cat doesn't have any dietary intolerances, and if she's not throwing up, you may not be able to tell unless you try it, this video plus cutting and packing capsules with pills has saved Betty's butt. She is normally a very chill cat. But she has strong opinions about being pilled or even having her mouth forced open. So when we hit upon this, oh my gosh! That changed everything. I now get liquid medicines compounded into capsules rather than the other way around.

Betty takes three capsules twice a day: AM is ondansetron, gabapentin, and an s. boulardii size four capsule. PM is ondansetron+prednisilone packed in the same capsule, gabapentin, and another s. boulardii. She takes each one off the carpet herself, meows for the next one, and purrs the whole time. I call Hills A/D her "cake frosting" because even her Dasuquin chews that she now things are "meh", she will eat those with just the lightest coating of A/D.