Budesonide vs Prednisolone?? Need help!

[Sillycat41]

My Jengo (who has CRF and possible IBD) has had diarrhea for a couple of months now. Started out with soft stools with a bit of red blood but progressively got worse. For the last few weeks he has had some watery stools and some formed stool with watery diarrhea. The vet put him on Tylan (Tylosin) powder and increased his Pred. from every other day to daily. No blood after the increase in Pred. but the Tylan isn't helping much. Now the vet wants to switch him from Pred to Budesonide saying that would help control the diarrhea. However I have read on the forums that some cats on Budesonide actually have diarrhea. I'm confused and need advice.

Also there is some confusion about whether the Budesonide should be enteric coated so that it passed thru the stomach and dissolves in the intestines. Can anyone confirm this? Some are using regular Budesonide.
Thanks. Barb

 

[mrsgreenjeens]

I have never heard of diarrhea being a side effect of Budesonide, however, it's definitely a common side effect of the Tylosin, even though it's often given for that very issue!

I have to ask, did your Vet ever do a fecal, particular a PCR to try to determine the cause of the diarrhea since it's lasting quite a long time? To me, if not, I would ask for one. It's possible he's got a parasite causing the problem. One of mine, although he's indoors only, developed Clostridium Perfengens, which caused ongoing diarrhea until we figured out the problem. I guess it's not really a parasite but more a bacterial inbalance.

I also want to ask if your Vet mentioned anything about food sensitivity. Often blood in the stool, (and a soft stool), indicate a food sensitivity, even if they have been eating the same food for a long time. I know this isn't answering your question about the Budesonide, but may still be helpful.

As to the enteric coating, I have no idea. I didn't know that was an option for this drug, since it needs to be prepared at a compounding pharmacy anyway (for cat size doses).

 

[stephanietx]

Budesonide is used in place of pred because it's not as likely to cause diabetes. Among IBD owners (in a group on FB), it's hit or miss on effectiveness. It does decrease inflammation, but helping with diarrhea is 50/50. It helps some but doesn't help other kitties. We used slippery elm bark syrup to help stop diarrhea with good success.

 

[Sillycat41]

I have never heard of diarrhea being a side effect of Budesonide, however, it's definitely a common side effect of the Tylosin, even though it's often given for that very issue!

I have to ask, did your Vet ever do a fecal, particular a PCR to try to determine the cause of the diarrhea since it's lasting quite a long time? To me, if not, I would ask for one. It's possible he's got a parasite causing the problem. One of mine, although he's indoors only, developed Clostridium Perfengens, which caused ongoing diarrhea until we figured out the problem. I guess it's not really a parasite but more a bacterial inbalance.

I also want to ask if your Vet mentioned anything about food sensitivity. Often blood in the stool, (and a soft stool), indicate a food sensitivity, even if they have been eating the same food for a long time. I know this isn't answering your question about the Budesonide, but may still be helpful.

As to the enteric coating, I have no idea. I didn't know that was an option for this drug, since it needs to be prepared at a compounding pharmacy anyway (for cat size doses).

Thanks for responding. Oh great... Tylosin can cause diarrhea!!

I'm sorry that I didn't mention in my post that Jengo did have 2 fecal tests done. First was just an in=-house "Fecal Centriugation" for $40 and 9 days later the vet sent a sample out to be analyzed... a Diarrhea RealPCR Panel Feli Comp" according to the bill. That one was $207 and the vet said what he has is like C-diff and put him on Tylosin. The vet could have told me that it was "Clostridium Perfengens" when he called with the results, but I am so stressed all the time I didn't write it down.

The PCR test was done the end of June and we are now into Aug. and Jengo still has diarrhea. I'm very worried as I can tell that he doesn't feel well. Jengo is also an indoor cat.

No, the vet didn't mention food sensitivity concerning this problem, but he did talk about it a couple of years ago when he said Jengo had IBD. The weird thing is that Jengo had a problem with constipation for a long time before this diarrhea problem started a couple of monts ago. I used to have to give him Miralax. He's also a very fussy eater so I give him whatever he'll eat plus syringe feed him extra so he doesn't lose weight.

Maybe the enteric coating is for humans. Also I read online that S. Boulardii probiotics can help calm the diarrhea. Ever tried it?

Thanks for your comments. Barb

 

[Sillycat41]

Budesonide is used in place of pred because it's not as likely to cause diabetes. Among IBD owners (in a group on FB), it's hit or miss on effectiveness. It does decrease inflammation, but helping with diarrhea is 50/50. It helps some but doesn't help other kitties. We used slippery elm bark syrup to help stop diarrhea with good success.

Thanks for the response. I have also read that Budesonide may or may not work. Poor Jengo has put up with diarrhea for a couple of months... different degrees of it. I do have slipery elm on the shelf... didn't know that it was good for diarrhea. I'll try that. Thanks for the help. Barb

 

[mrsgreenjeens]

OK, now that I know that you've had the PCR done and it came back positive for something, that's...something. Just wish I know what it came back positive for. My cat who was positive for Clostridium Perfengens ALSO used to be on Miralax before his episodes because he had problems with constipation! Then the opposite which was a sign something was definitely wrong. For the C. Perf we started him on S. Boulardi with MOS (it's the MOS part that is imperative for taking care of business here) and increased his fiber. I hate it, but we put him on the highest dry food I could find, which was Iams Hairball in the orange bag. I could only find it on the internet, but the fiber content is 8.5%, much higher even than the prescription gastro foods. I didn't feed dry food before, but he wouldn't eat physillium husk in his wet food, so we went with plan B. Almost immediately, his diarrhea cleared up and I could tell he was feeling better. Before, he was going into the litter box and having the squirts many times per day, His Vet originally wanted to put him on Tylosin, but I had already read about using the S. Boulardi with MOS for this issue and said I wanted to try it first before going with antibiotics. She agreed to let me try, and voila! I continued for several months, just in case, and still add in some of the high fiber food now for them at night, just because. I don't give them much now because it made their stool ginormous! But the Vet said that's how it clears it up, by passing out out of their intestines.

Hope this helps

 

[stephanietx]

This probiotic might also help. It's been recommended in the past for pets with issues. The human version helps treat c. diff, especially with cancer patients.

Nexabiotic Probiotics for Cats Diarrhea Treatment Supplement, 30 Doses

 

[fionasmom]

I have used Nexabiotic for Jamie because it is completely tasteless and mixes into any wet food.

 

[Sillycat41]

I have used Nexabiotic for Jamie because it is completely tasteless and mixes into any wet food.

Thanks... I'll look into this one.

 

[Sillycat41]

This probiotic might also help. It's been recommended in the past for pets with issues. The human version helps treat c. diff, especially with cancer patients.

Nexabiotic Probiotics for Cats Diarrhea Treatment Supplement, 30 Doses

OK, now that I know that you've had the PCR done and it came back positive for something, that's...something. Just wish I know what it came back positive for. My cat who was positive for Clostridium Perfengens ALSO used to be on Miralax before his episodes because he had problems with constipation! Then the opposite which was a sign something was definitely wrong. For the C. Perf we started him on S. Boulardi with MOS (it's the MOS part that is imperative for taking care of business here) and increased his fiber. I hate it, but we put him on the highest dry food I could find, which was Iams Hairball in the orange bag. I could only find it on the internet, but the fiber content is 8.5%, much higher even than the prescription gastro foods. I didn't feed dry food before, but he wouldn't eat physillium husk in his wet food, so we went with plan B. Almost immediately, his diarrhea cleared up and I could tell he was feeling better. Before, he was going into the litter box and having the squirts many times per day, His Vet originally wanted to put him on Tylosin, but I had already read about using the S. Boulardi with MOS for this issue and said I wanted to try it first before going with antibiotics. She agreed to let me try, and voila! I continued for several months, just in case, and still add in some of the high fiber food now for them at night, just because. I don't give them much now because it made their stool ginormous! But the Vet said that's how it clears it up, by passing out out of their intestines.

Hope this helps

I emailed the vet clinic and had them send me the results from Jengo's PCR test. The two results the vet highlighted were C. perfringens Alpha Toxin (CPA) Gene RealCPR = positive and also C. perfringens Alpha Toxin (CPA) Gene Interpretation = high levels of CPA gene copies present. The only thing the vet put him on was a pinch of Tylosin twice a day and continue with the Proviable. I read that psyllium helped so added a little to a couple of wet food meals a day. Unfortunately none of this is working... he still has watery stools with lumps and sometimes squirts of mostly watery stool. Your description of several trips a day to the litter box is the same here.

I had ordered some Jarrow S. Boulardii but was afraid to give it to him. Finally did Thurs. night and an hour later he vomited a yellow liquid. He rarely vomits so it had to be the S. Boulardii as that was the only thing I did different.

I can tell that the poor little guy doesn't feel well and he's very thin. Last week the vet prescribed Budesonide since he has IBD and some blood in his stools. Finally got it yesterday and gave him one last night... hope this works soon as I'm not getting enough sleep cleaning the litter box every time he poops.

Since he's been on Tylosin for about a month and it's not helping, I'm thinking about trying what you did... stop the Tylsoin and just use S. Boulardii and extra fiber. I'm so worried about losing him to this chronic diarrhea after managing his CRF and IBD for so long. Thanks again for your help.

 

[Sillycat41]

I emailed the vet clinic and had them send me the results from Jengo's PCR test. The two results the vet highlighted were C. perfringens Alpha Toxin (CPA) Gene RealCPR = positive and also C. perfringens Alpha Toxin (CPA) Gene Interpretation = high levels of CPA gene copies present. The only thing the vet put him on was a pinch of Tylosin twice a day and continue with the Proviable. I read that psyllium helped so added a little to a couple of wet food meals a day. Unfortunately none of this is working... he still has watery stools with lumps and sometimes squirts of mostly watery stool. Your description of several trips a day to the litter box is the same here.

I had ordered some Jarrow S. Boulardii but was afraid to give it to him. Finally did Thurs. night and an hour later he vomited a yellow liquid. He rarely vomits so it had to be the S. Boulardii as that was the only thing I did different.

I can tell that the poor little guy doesn't feel well and he's very thin. Last week the vet prescribed Budesonide since he has IBD and some blood in his stools. Finally got it yesterday and gave him one last night... hope this works soon as I'm not getting enough sleep cleaning the litter box every time he poops.

Since he's been on Tylosin for about a month and it's not helping, I'm thinking about trying what you did... stop the Tylsoin and just use S. Boulardii and extra fiber. I'm so worried about losing him to this chronic diarrhea after managing his CRF and IBD for so long. Thanks again for your help.

OK, now that I know that you've had the PCR done and it came back positive for something, that's...something. Just wish I know what it came back positive for. My cat who was positive for Clostridium Perfengens ALSO used to be on Miralax before his episodes because he had problems with constipation! Then the opposite which was a sign something was definitely wrong. For the C. Perf we started him on S. Boulardi with MOS (it's the MOS part that is imperative for taking care of business here) and increased his fiber. I hate it, but we put him on the highest dry food I could find, which was Iams Hairball in the orange bag. I could only find it on the internet, but the fiber content is 8.5%, much higher even than the prescription gastro foods. I didn't feed dry food before, but he wouldn't eat physillium husk in his wet food, so we went with plan B. Almost immediately, his diarrhea cleared up and I could tell he was feeling better. Before, he was going into the litter box and having the squirts many times per day, His Vet originally wanted to put him on Tylosin, but I had already read about using the S. Boulardi with MOS for this issue and said I wanted to try it first before going with antibiotics. She agreed to let me try, and voila! I continued for several months, just in case, and still add in some of the high fiber food now for them at night, just because. I don't give them much now because it made their stool ginormous! But the Vet said that's how it clears it up, by passing out out of their intestines.

Hope this helps

P.S. I forgot to ask you how much S. Boulardii you gave? I only put a little from the Jarrow capsule into a #4 capsule because I was afraid to give him too much. Maybe it wasn't enough. ????

 

[Sillycat41]

I have used Nexabiotic for Jamie because it is completely tasteless and mixes into any wet food.

Okay, thanks. I'll check out Nexabiotic... never heard of this one.

 

[mrsgreenjeens]

On the S. Boulardi, I know I have said this many times on different threads, but be sure it contains MOS. I never was able to give full doses because my guy hated it in his food. I had to put it in my palm and cover it with FortiFlora to get him to lick it up. Doing that I couldn't really use too much. He probably didn't even get a half capsule per day, Based on that, it was probably the high fiber that did the trick. Since your guy has IBD, I'm guessing you don't want to feed him what I fed, so hopefully some psyllium husk will work well. You might need to use a little more of that.

 

[stephanietx]

If he has watery/runny stools, try adding slippery elm bark syrup to his wet food or syringing it into his mouth. This really helped my kitty when he was having raging diarrhea.

 

[Sillycat41]

On the S. Boulardi, I know I have said this many times on different threads, but be sure it contains MOS. I never was able to give full doses because my guy hated it in his food. I had to put it in my palm and cover it with FortiFlora to get him to lick it up. Doing that I couldn't really use too much. He probably didn't even get a half capsule per day, Based on that, it was probably the high fiber that did the trick. Since your guy has IBD, I'm guessing you don't want to feed him what I fed, so hopefully some psyllium husk will work well. You might need to use a little more of that.

The Jarrow S. Boulardii does have MOS. I started giving him about a 1/4 of a capsule in a #4 capsule that I use. I also put psyllium in a couple of his 8 small meals that he eats a day. Yesterday I read that Tylosin and actually cause diarrhea sometimes so I backed off on that. He's been one 2 doses a day for weeks and no sign of improvement.

Unfortunately it's so hard to get answers from my vet in a timely manner. He doesn't answer email for days and only works 3 days a week. We don't have an emergency vet clinic in our small city and all the other vets aren't accepting new clients. This is why I ask questions on the forums to see what others have done to help their kitties since I can't get answers from my vet.

I weighed Jengo this morning and he's lost a little more weight. After making it this long with CRF and IBD, I can't believe he's going to lose the battle because of chronic diarrhea. Breaks my heart.

 

[Sillycat41]

If he has watery/runny stools, try adding slippery elm bark syrup to his wet food or syringing it into his mouth. This really helped my kitty when he was having raging diarrhea.

Okay thanks. I have to find the "recipe" and do that today!

 

[stephanietx]

Here are the instructions for the slippery elm bark syrup.

• Into a small saucepan place 1/2 cup cold water and 1 teaspoon powdered slippery elm bark.
• Whip with a fork or whisk.
• Bring to simmer over low flame, stirring constantly.
• Simmer 1 or 2 minutes or until slightly thickened to the consistency of a raw egg white.
• Cool and refrigerate. Keeps 7 or 8 days.
• Give 1/4 teaspoon of syrup for an average-size cat (again, about 10 pounds) 5 minutes before a meal to minimize diarrhea, or to soothe and heal mouth ulcers.

 

[Sillycat41]

Here are the instructions for the slippery elm bark syrup.

• Into a small saucepan place 1/2 cup cold water and 1 teaspoon powdered slippery elm bark.
• Whip with a fork or whisk.
• Bring to simmer over low flame, stirring constantly.
• Simmer 1 or 2 minutes or until slightly thickened to the consistency of a raw egg white.
• Cool and refrigerate. Keeps 7 or 8 days.
• Give 1/4 teaspoon of syrup for an average-size cat (again, about 10 pounds) 5 minutes before a meal to minimize diarrhea, or to soothe and heal mouth ulcers.

Thanks for sending the recipe. I'm busy this morning cleaning the litter box from another bout of watery diarrhea. Hope the slippery elm helps. I did notice that some people just add it to wet food instead of making a syrup. Is there an advantage to cooking it?

 

[BellaBlue82]

I'm so sorry you're going through this. When I was having issues with my GA cat Nico, this combination seemed to help:
1/2 Jarrow S boulardi a day (2 #4 capsules, one AM and one PM.) One 1mg budesonide pill a day. SEB during the middle of the day, so as not to disturb the absorption of the other medicines/supplements.
After about a week or two of this, I could definitely see his stools firm up.
Tylosin and metro did nothing for him, only made his stools worse. So I stopped them after speaking with his vet.
I wish you the best of luck, hopefully he gets some relief soon!!

 

[stephanietx]

Thanks for sending the recipe. I'm busy this morning cleaning the litter box from another bout of watery diarrhea. Hope the slippery elm helps. I did notice that some people just add it to wet food instead of making a syrup. Is there an advantage to cooking it?

I have tried both and it seemed to work better once "cooked". I could more easily regulate the dose as well.