Worried about weaning cat off Prednisolone after long term use!!!

[Sillycat41]

Would like to know if someone else has had this experience. My old vet put my Jengo on Prednisolone for IBD and he's been on it for about 2 years. I've read and heard from group members that long term Prednisolone use isn't good so I went to another vet for a 2nd opinion. She said that we need to get him off of it and wrote out a 35 days weaning schedule. It's only been day 10 and something has changed.

He used to walk on his cat wheel every morning a half hour to an hour plus several times during the day. This morning he had no interest in walking... couldn't even coax him. Took him to the 2nd vet again... she did a blood test to check it he was anemic or white blood count was high. Nothing unusual. He napped for a couple of hours this afternoon and then ate a meal. I spun the cat wheel and he walked a few steps but really had no interest. Decided to take another nap. I'm very worried as this behavior came on kind of suddenly.

I'm wondering if being on Prednisolone for such a lot time and then cutting back on it could have causes this decline. Has anyone else had experience with cutting back on Prednisolone and having problems?? I'm a nervous wreck!! :-(

 

[Joxer]

What does Jengo's weaning schedule (off Prednisolone) look like? From starting dose X, to intermediate dose Y after 10 days, to final dose Z after 35 days?

If the underlying cause of IBD has not been addressed (through a change of diet, for example), intestinal inflammation could return after lowering or stopping Prednisolone. Of course, as you say, the drug has some problematic long-term side effects. It can be a tough call.

 

[silent meowlook]

My cat has been on Prednisolone for three years and is doing well. She started with IBD and then later on, intestinal lymphoma. I have tried to wean her off or further reduce her Prednisolone dose of 5 mg every other night, but she doesn’t do as well, so I keep her on it.

Not a vet, but in my opinion and what I have read, cats tolerate low doses of Prednisolone well.

 

[stephanietx]

We have a cat on Prednisolone for IBD right now. He was on 5mg every other day, but that wasn't cutting it for him, so she bumped us up to 10mg once a day for 14 days, then back down to 5mg for another 14 days, then every other day. He seems to do well on 5mg daily. When he was in last week, the vet checked his blood sugar and it was great, so right now, we're not concerned about diabetes.

I'm also not a vet or a vet tech and am only speaking from experience with my kitty.

 

[Sillycat41]

My cat has been on Prednisolone for three years and is doing well. She started with IBD and then later on, intestinal lymphoma. I have tried to wean her off or further reduce her Prednisolone dose of 5 mg every other night, but she doesn’t do as well, so I keep her on it.

Not a vet, but in my opinion and what I have read, cats tolerate low doses of Prednisolone well.

What does Jengo's weaning schedule (off Prednisolone) look like? From starting dose X, to intermediate dose Y after 10 days, to final dose Z after 35 days?

If the underlying cause of IBD has not been addressed (through a change of diet, for example), intestinal inflammation could return after lowering or stopping Prednisolone. Of course, as you say, the drug has some problematic long-term side effects. It can be a tough call.

Sorry I'm so slow getting back to you. I misplaced the schedule the vet wrote out for me. Okay, here's what she suggested: since he's currently on 2.5 mg twice a day, reduce it to 2.5 mg once a day for 14 days. Then reduce to 2.5 mg every other day for 14 days. Next reduce to 1.25 mg every other day for 7 days.... then stop.
I guess this sounds reasonable, right?? I am worried about the intestinal inflammation returning after stopping it. Today was day 13 on 2.5 mg a day... so far I haven't noticed any major changes. He possibly is not eating as much but that's hard to tell because he's always been a fussy eater. If he starts vomiting regularly again I may have to rethink this plan.

 

[Sillycat41]

My cat has been on Prednisolone for three years and is doing well. She started with IBD and then later on, intestinal lymphoma. I have tried to wean her off or further reduce her Prednisolone dose of 5 mg every other night, but she doesn’t do as well, so I keep her on it.

Not a vet, but in my opinion and what I have read, cats tolerate low doses of Prednisolone well.

Wow... that seems pretty rare from the searches I've done.... being on 5 mg a day! One of my major concerns that the IBD could turn into lymphoma from what I read. Now I'm torn about which vet to trust... keeping him on Pred. or getting him off??? Is 5 mg a day considered a lot dose???

 

[Sillycat41]

We have a cat on Prednisolone for IBD right now. He was on 5mg every other day, but that wasn't cutting it for him, so she bumped us up to 10mg once a day for 14 days, then back down to 5mg for another 14 days, then every other day. He seems to do well on 5mg daily. When he was in last week, the vet checked his blood sugar and it was great, so right now, we're not concerned about diabetes.

I'm also not a vet or a vet tech and am only speaking from experience with my kitty.

What symptoms did he have when you said "5 mg every other day wasn't cutting it for him"???
Wondering what I should watch for... vomiting?? intestinal issues?? So far we don't have any blood sugar issues with Jengo.

 

[stephanietx]

He has very severe diarrhea and loose stools right now without pred. We are in the process of transitioning his food to something more bland and easier on his system, but he was soooo inflamed and bloated that she put him on the 10mg for 14 days. When he's really inflamed, he also pees outside the box because nothing feels good to him internally. We're getting there, but it's very slow progress. Today is his last day on 10mg pred. We've also added Simethicone (baby gas drops) to help with excess bloating and gas.

 

[Joxer]

Sorry I'm so slow getting back to you. I misplaced the schedule the vet wrote out for me. Okay, here's what she suggested: since he's currently on 2.5 mg twice a day, reduce it to 2.5 mg once a day for 14 days. Then reduce to 2.5 mg every other day for 14 days. Next reduce to 1.25 mg every other day for 7 days.... then stop.
I guess this sounds reasonable, right?? I am worried about the intestinal inflammation returning after stopping it. Today was day 13 on 2.5 mg a day... so far I haven't noticed any major changes. He possibly is not eating as much but that's hard to tell because he's always been a fussy eater. If he starts vomiting regularly again I may have to rethink this plan.

I am not a vet, but that seems like a reasonable tapering schedule. Prednisolone can have a lot of nasty side effects when used for a long time, especially at high doses. If you can wean Jengo off of it, or even just get him down to a lower dose, he will be healthier for it. If you get to the point where he stops eating, then you might have to raise his dose again. But it is worth trying to at least move him to a lower dose.

I recently lost a cat, Xena, who was on 5 mg per day of Prednisolone for the last 3.5 months of her life. I suspect that the Prednisolone, initially required to get her to eat again, should have been tapered down after a month or two. I wish that I had researched it more at the time. It initially seemed like such a wonder drug (Wow! My cat is eating again!) that I did not think of it as potentially dangerous.

 

[PushPurrCatPaws]

I have a cat that has been on long-term Pred use for her allergic bronchitis (essentially, her asthma). I don't personally know about weaning off of Pred use when it is used for IBD, but I do think that if Pred use is more than 3-6 months, then a longer period of weaning off of it is warranted - so that the cat's metabolism or other issues have a chance to "even out". A cat get get pretty reliant upon Pred metabolically.

I am not a vet, so I would absolutely suggest following your vet's instructions -- with these caveats: check in with the vet if any signs of lethargy, diarrhea, or vomiting, etc.; and make a phone call appt (or in-person appt) with them if you feel you want to further discuss switching to a longer weaning-off time-frame, if you are worried.

If I ever wean my own cat off of Pred, I would feel much more comfortable having a looong weaning period -- longer than 35-40 days. She's been on it for several years, and I would rather go for a weaning period of 2-4 months, which, to my mind, would be safer for my cat.

 

[Sillycat41]

I have a cat that has been on long-term Pred use for her allergic bronchitis (essentially, her asthma). I don't personally know about weaning off of Pred use when it is used for IBD, but I do think that if Pred use is more than 3-6 months, then a longer period of weaning off of it is warranted - so that the cat's metabolism or other issues have a chance to "even out". A cat get get pretty reliant upon Pred metabolically.

I am not a vet, so I would absolutely suggest following your vet's instructions -- with these caveats: check in with the vet if any signs of lethargy, diarrhea, or vomiting, etc.; and make a phone call appt (or in-person appt) with them if you feel you want to further discuss switching to a longer weaning-off time-frame, if you are worried.

If I ever wean my own cat off of Pred, I would feel much more comfortable having a looong weaning period -- longer than 35-40 days. She's been on it for several years, and I would rather go for a weaning period of 2-4 months, which, to my mind, would be safer for my cat.

 

[Sillycat41]

Thanks for the response. You made a good point... the longer the cat has been on Pred, the longer the weaning period should be. He has been to two vets... the 1st one prescribed 2.5 mg AM & PM. The 2nd vet wants him off it all together. I don't know who to trust. I guess I'm thinking about taking the middle ground and cutting it back to a dose every other day but not totally off it. Hard to get in touch with the vets around here because they are super busy. Waiting two days for a call back.

 

[Sillycat41]

My cat has been on Prednisolone for three years and is doing well. She started with IBD and then later on, intestinal lymphoma. I have tried to wean her off or further reduce her Prednisolone dose of 5 mg every other night, but she doesn’t do as well, so I keep her on it.

Not a vet, but in my opinion and what I have read, cats tolerate low doses of Prednisolone well.

Thanks for the response. Is 5 mg every other night considered a low dose?? I was thinking about asking the vet if we could just leave him on maybe 2.5 mg every other night and see how that goes. I couldn't find anything in a search about what is considered a low maintenance dose. I have noticed that he seems to have less of an appetite since I reduced the dose. Wish the vet would call back... super busy around the holidays because of time off.

 

[silent meowlook]

I tried tapering my cat down to 2.5 mg. EOD and she didn’t do well.
5 mg a day is usually well tolerated in cats according to what I have read and witnessed.

 

[Sillycat41]

I tried tapering my cat down to 2.5 mg. EOD and she didn’t do well.
5 mg a day is usually well tolerated in cats according to what I have read and witnessed.

Thanks for your response. You said that " she didn’t do well." What exactly did you notice... wonder if you could give some examples.

 

[silent meowlook]

She was more lethargic and started vomiting again and less interested in food. Also looked like she didn’t feel well.

 

[Sillycat41]

She was more lethargic and started vomiting again and less interested in food. Also looked like she didn’t feel well.

Okay, thanks. He hasn't started vomiting again but he whines in the litter box a lot. :-(