Prednisolone

[flowergirl]

As I've posted about in my other thread, my cat Pierre had dental surgery (4 extractions) on Tuesday. His take home meds were bupe and prednisolone, and we finished the main course of both last night. He was on the pred for 3 days at home (and I think they also gave an initial shot at the vet) and starting today we move to once a day for 3 days. I've noticed today he seems more tired again, and has spent most of the day on the bed. He seems alert and is eating fine, just doesn't seem to want to do much. I'm not sure if this could be withdrawal from the pred? He's been on it for such a short time, but I've read it can have a difficult withdrawal. Has anyone had any withdrawal issues with such a short course? He could also still be recovering from the shock of surgery and anesthesia, but he seemed to have more energy yesterday.

 

[FeebysOwner]

He was on the pred for 3 days at home (and I think they also gave an initial shot at the vet) and starting today we move to once a day for 3 days.

Hi. I don't have experience with this, but wanted to clarify something - he has been moved to once a day for 3 days from how many times for 3 days before that?

I think if I were you I would call the vet and ask about his lethargy.

And, hopefully other members who have used Pred will come along soon and offer their first hand experience.

 

[flowergirl]

Hi. I don't have experience with this, but wanted to clarify something - he has been moved to once a day for 3 days from how many times for 3 days before that?

I think if I were you I would call the vet and ask about his lethargy.

And, hopefully other members who have used Pred will come along soon and offer their first hand experience.

Hi FeebysOwner. He was on it twice daily for the first three days after surgery. Starting today, its once per day for 3 days (so he will get a dose tonight).

Unfortunately the dental vet is closed for the weekend. I am going to give my regular vet a call before they close today to see if it warrants an ER visit. He did come out and play with his ribbon toy, and got up and followed me around a little bit this afternoon, so it could just be normal recovery.

 

[FeebysOwner]

Let us know what his regular vet says!!

 

[flowergirl]

Let us know what his regular vet says!!

OK, they said that it doesn't sound like an emergency because he is still eating, using the litter box, etc. But they recommended that if he doesn't seem better by the morning I should probably take him to an ER vet to make sure nothing is wrong. So I will continue to watch him for signs of worsening tonight and then see how he is in the morning. It's just weird to me that he seemed better yesterday than today.

One thing that came to mind is possible constipation. He's gone some since he's been back home, but not totally normal yet and I would bet that it's bugging him. He has had a lot of extra water with his food lately and with the reduction of bupe I'm hoping he has some better production there soon.

 

[PushPurrCatPaws]

Hello, flowergirl ! I am not sure that five or six days of Pred, using with the very responsible tapering off of it that your vet instructed for you would cause too many noticeable symptoms or behavior changes. (I've had some experience with Pred use in my cat.) But with just 2-3 days of buprenorphine use, a kitty can begin to get constipated for sure! Was he on 5-6 days of bupe? So, that could be it -- but be sure follow your vet's instructions and watch him closely, or take him in if concerned -- hang in there! How is he doing this morning?

 

[flowergirl]

Well, we are at the emergency vet. He was still acting lethargic this morning and seemed like he developed a little congestion overnight too. So far we've only seen the tech, and he said he doesn't see anything too obvious but the doctor should be in soon. One good thing so far is no fever.

 

[FeebysOwner]

Glad you took him in! Even so, I hope there is nothing really wrong - or if there is, it is easily taken care of!

 

[flowergirl]

He is off getting an xray to check for constipation. The vet says that is the first thing to rule out, but he doesn't seem like he has an infection (yay).

 

[flowergirl]

Oh, and she suggested moving him to gabapentin instead of bupe, but since I'm tapering bupe anyway for him to go off of it, I'm not sure that makes a lot of sense.

 

[FeebysOwner]

Oh, and she suggested moving him to gabapentin instead of bupe, but since I'm tapering bupe anyway for him to go off of it, I'm not sure that makes a lot of sense.

Maybe the vet is worried that he might need something to help with pain for a little while longer? Just ask what her reasoning is.

 

[flowergirl]

Maybe the vet is worried that he might need something to help with pain for a little while longer? Just ask what her reasoning is.

I asked if she thought he even still needed a pain med. She initially thought maybe he had lingering oral pain and also discomfort from the constipation. I think she is just trying to get him off the bupe right away.

His xray showed that he has a lot of stool built up, so they recommended an enema, which he is getting right now. They are also sending me home with lactulose. Does anybody have experience with that one?

 

[PushPurrCatPaws]

... They are also sending me home with lactulose. Does anybody have experience with that one?

What are the vet's instructions for that? I haven't ever had to use it with a kitty, but I know other members have. It could be that he may only "need" it for a few days as going off of bupe will help things get back to normal anyway.

Did you taper him off of the bupe? After 3 or so days, a cat's body can really get used to having that pain med and a slowish taper will help with his mood. If it is stopped abruptly, it can make a cat seem a bit quieter or less active (like you describe in your first post) as they adjust to not having that medication in them. Some cats will be jumpier or more short-tempered, so it just depends. A week or so later, they perk up more and feel more normal.

 

[FeebysOwner]

I know lactulose is not only used to help with constipation, but it also contains an ingredient that helps clear the body of toxins. I suppose the thought process for using lactulose (vs. something like Miralax) on Pierre is to help clear any toxins that might have built up in the system due to improper functioning of the bowel - not to mention the pain meds that would have also been part of that build up.

 

[flowergirl]

We are home from the vet. He hasn't pooped yet from the enema but hopefully it'll be soon. He went straight to his box to pee and now he's finishing his breakfast. I really hope this clears up his remaining issues.

My only concern with the lactulose is that he generally has softish stools anyway. This is something we've been trying to manage through diet. I'm a little worried it might cause diarrhea, but I think for now it's more important to just get him back to normal. The instructions on it are twice a day for 5 days. I don't have the dosage in front of me at the moment. I wish I could talk to his normal vet before proceeding, but unfortunately they are closed until tomorrow so I think I have to just go with it today.

 

[flowergirl]

Did you taper him off of the bupe? After 3 or so days, a cat's body can really get used to having that pain med and a slowish taper will help with his mood. If it is stopped abruptly, it can make a cat seem a bit quieter or less active (like you describe in your first post) as they adjust to not having that medication in them. Some cats will be jumpier or more short-tempered, so it just depends. A week or so later, they perk up more and feel more normal.

I started a taper or 1ml once a day last night based on what the regular vet said. But the ER vet doesn't think he should have any more of it, hence the gabapentin. She did say when she had him in the back he was letting her touch his mouth and she doesn't think there is any pain there, so the gabapentin is really only if he seems like he needs it.

 

[stephanietx]

Pain meds can lead to constipation, so the pain meds may be the culprit here. I have used lactulose in the past and it works, but what we found worked better was going to a mostly wet food diet and adding in plain canned pumpkin 2x a day when feeding. When my girl had extractions a couple of years ago, we only did pain meds for 3 days.

 

[flowergirl]

I sent an email to my primary vet to see if they think the whole 5 day course of lactulose is appropriate. I wish it wasn't Sunday so I could talk to them before I start it, but a couple of doses will probably be okay for him. I also asked if they can come by on Tuesday to check on him (they are a home vet). Unfortunately I have a work commitment tomorrow so we can't do it then. We are also expecting a snowstorm.

After pooping from the enema, Pierre ate and went right back to sleep and has stayed that way. I'm a little down as I was hoping to see a turnaround once he got some of that out of him. I am trying to hang in there.

 

[stephanietx]

Pooping is hard work, especially if you've had an enema. Enemas aren't easy on the system, but they are necessary at times. It also doesn't all come out at one time and he can end up with a little bit of diarrhea. He also might be worn out from the vet visit. Give him a day to recuperate and if he doesn't bounce back, then be concerned.

 

[flowergirl]

Thank you for the pep talk. It's been a long week and I'm just anxious to finally have my boy back.