Depo-medrol in a diabetic/CKD cat

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
The situation: In November, 2023, I had my A/C unit fail and it had to be ripped out of my 950 sq ft. place. They had the front door open for 7 hours to the pouring rain whilst they removed the 20 yr old air handler, and stirred up dust, mold, and god knows what else.

Immediately thereafter, my then-13 yr old Maine Coon mix started coughing. I had inflamed corneas in both eyes and couldn't wear contacts or see, even without them. My car was in the shop 9 days over the week of Thanksgiving and the first thing I did when I got it back was go to the eye doctor for steroid drops. As soon as I could see, I took him to his usual vet at "Big Name Chain" conveniently across the street. They did a blood test with my report of coughing, sneezing, nasal discharge, lethargy, loss of appetite, and diarrhea. The blood test came back alarming with nearly every level out of range, especially RBC, liver, kidneys etc. I was panicked. They said to come back in 48 hours to check if his RBCs were crashing and whether he needed a blood transfusion. Did that and his test WAS NORMAL. Even kidney function was "as usual" for Stage 2. They explained there must have been "artifacts in the vial" or some BS after charging me $450 for the bogus test and $150 for the re-test. I was so upset I just wanted to get out of there, not even argue it all. They said he was fine. Probably allergies. No meds, nothing.

Over the holidays he seemed stable, just with an occasional sneeze/cough and needing a crumb of mirtaz to keep eating. After the holidays, I decided to switch vets and immediately took him to a vet a further drive away but one that was highly recommended. They did an X-ray and saw some bronchial pattern but it didn't look bad. They said if he's only coughing once a day, just keep an eye on him for a week or two and see if he's any better or worse.

He got worse. The croupy. deep cough was loud enough to wake me up at night. Took him back again. A different vet said he has bronchitis...probably had it for 3 months!. Gave him Convenia, and a take home prescription for prednisone and metronitazole. The problem was, with his picky eating there was no way to put it in his food and guarantee he would ever eat it. So I crushed the pills, mixed with juice from his wet food, and put it in a syringe. Even so, he was drooling like mad and puked 50% of the time within minutes/hours. I think he might have gotten 50% of the meds over a 7 day period.

So I called and asked what to do. Since he was diabetic once (in remission with diet) I had all the stuff to do a blood glucose test. They asked what his levels were at 7 days of prednisone and I got 141, 65 and 127 on three strips. I always take a few just because of the variables between the sample, strip, meter etc. The vet said she was not too concerned that his levels were "only" that high on the prednisone and that she was OK with giving him a steroid shot to make sure he kicked this cough.

So I took him in today and they gave him Depo. I plan to test him again tomorrow. They said if he's over 300 to take him in again. I don't have any insulin left since that was 2021 and he hasn't needed it since.

QUESTION IS: Will one Depo shot possibly send him back into diabetes? I know that stuff can last weeks or months. Is it possible we may have to go back on insulin again and if so, would it be permanent?? We've done so well with a wet food/no carb diet. I hope this steroid doesn't send him over the edge again.

Does anyone have any experience with this? I don't expect he will need another shot or regular shots. It's just a one-time thing to kick this lower respiratory infection thanks to other vets who charged me $$$ for no answers.

Thanks in advance!

Today is Romeo's 14th birthday...February 14th!💗💗😻
 

Attachments

BeccaCat

TCS Member
Adult Cat
Joined
Dec 7, 2021
Messages
284
Purraise
552
I’m sorry your kitty is going through all of this. I don’t know much about diabetes in cats, but I think one shot of depo should be okay. My Tessa gets it every 7 weeks. We do watch her for symptoms of diabetes but in her severe asthma case, she needs it every 7 weeks. So far she has been doing well on it (for about a year).
Tessa was sick when we adopted her and as I said has severe asthma.She has had a couple bouts of bronchitis that required antibiotics. The covenia didn’t really help her that much. What did help her much more was Azithromycin. It was a liquid and we gave it to her with a syringe (definitely easier if you have a helper to hold the cat). I hope he feels better soon. Happy Birthday Romeo!
 
  • Thread Starter Thread Starter
  • #3

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
Thank you! Fingers crossed it doesn't spike him too badly. My 17+ yr old former feral gets Depo every 6 weeks for allergies, asthma, IBS, etc and he's never had an issue but just worried about Romeo since he once went full diabetic on me. I took him off all dry food and he had two weeks of insulin in 2021 and that was the end of it...but it was a nightmare. I just don't want this bronchitis (also he's FHV+) to trigger another swing to the insulin resistant side.

I really want to find another solution for the old feral cat too. One year of Depo every 6 weeks can't be good and now it seems like it isn't even working like it did. Wish there was a non-steroidal way to help allergies/dermatitis/food allergies.
 

silent meowlook

TCS Member
Staff Member
Forum Helper
Joined
Nov 10, 2014
Messages
3,577
Purraise
6,722
He is very beautiful!!!

Has all the dust etc. cleared now in your house?
I am wondering why the depo? I guess for inflammation. Do they think he has asthma? Was his white blood cell count okay? Did they test him for any fungal? There is a fungal panel that can be done. It should include Cryptococcus.

I would do routine checks on his glucose for the next two weeks. I don’t know that I would do another depo injection if I were you.

I would ask your vet about nebulizing treatments or inhaled treatments as opposed to another injection.
 
  • Thread Starter Thread Starter
  • #6

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
He is very beautiful!!!

Has all the dust etc. cleared now in your house?
I am wondering why the depo? I guess for inflammation. Do they think he has asthma? Was his white blood cell count okay? Did they test him for any fungal? There is a fungal panel that can be done. It should include Cryptococcus.

I would do routine checks on his glucose for the next two weeks. I don’t know that I would do another depo injection if I were you.

I would ask your vet about nebulizing treatments or inhaled treatments as opposed to another injection.
Yes, all of the "fallout" has cleared, but the junk that I think caused his bronchitis and my eye issues stems from that A/C air handler removal. I was kinda surprised to hear that the plan was Depo today also...given he was on a 1-week regimen of prednisone which was marginally effective due to him throwing it up but also it didn't manage to raise his glucose much. I'm worried about the longer lasting effects of the Depo given his previous diabetes history.

Romeo has FHV related recurring rhinitis and upper respiratory stuff, but not this kind of thing. He isn't asthmatic like the 17+ yr old feral who has attacks daily (and now even with Depo which is why I want him off if it if it isn't helping anymore).

I do have a nebulization box I built and I was putting Romeo (and old man feral Squeaky) in it for 20 min at a time with just sterile saline but it didn't seem to help much in this case. It DID help Romeo in past upper respiratory issues due to FHV flare ups, but neither the nebulization box nor the L-Lysine (Viralys) did anything to help what he currently has.
 
  • Thread Starter Thread Starter
  • #7

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
For your former feral, I would ask about an inhaler for cats.
Yes, he has an Aerokat inhaler and albuterol for episodes between Depo shots. Poor guy has food allergies, dermatitis, asthma, environmental allergies...he has all of his teeth out due to severe stomatitis, and clearly, he has an overactive immune system. The Depo was controlling his dermatitis, itching, IBS and asthma for a while but now he needs an inhaler right after the shot, itching like mad and I've got him on the last novel protein we haven't tried for food allergies. We tried the hydrolyzed Hills and he barfed it up immediately. I just don't like that he's been on Depo for a year and it doesn't seem to be helping at all now. Not sure what to do next....
 

silent meowlook

TCS Member
Staff Member
Forum Helper
Joined
Nov 10, 2014
Messages
3,577
Purraise
6,722
Yes, he has an Aerokat inhaler and albuterol for episodes between Depo shots. Poor guy has food allergies, dermatitis, asthma, environmental allergies...he has all of his teeth out due to severe stomatitis, and clearly, he has an overactive immune system. The Depo was controlling his dermatitis, itching, IBS and asthma for a while but now he needs an inhaler right after the shot, itching like mad and I've got him on the last novel protein we haven't tried for food allergies. We tried the hydrolyzed Hills and he barfed it up immediately. I just don't like that he's been on Depo for a year and it doesn't seem to be helping at all now. Not sure what to do next....
It may be time to ask for a referral to a specialist. Sometimes these complicated cases are too much for regular vets to handle.
Do you have Fluticazole as well as albuterol?
With the nebulizer, drugs are used as well as the saline, but you would need to talk to your vet sbout that.
 

BeccaCat

TCS Member
Adult Cat
Joined
Dec 7, 2021
Messages
284
Purraise
552
I’d ask about fluticasone as well. Tessa uses it and it helps her a great deal. Are you in the USA? It can be very expensive. Our pharmacy thankfully accepts GoodRx for the cat, which helps reduce the cost by over half.
 
  • Thread Starter Thread Starter
  • #10

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
He is very beautiful!!!

Has all the dust etc. cleared now in your house?
I am wondering why the depo? I guess for inflammation. Do they think he has asthma? Was his white blood cell count okay? Did they test him for any fungal? There is a fungal panel that can be done. It should include Cryptococcus.

I would do routine checks on his glucose for the next two weeks. I don’t know that I would do another depo injection if I were you.

I would ask your vet about nebulizing treatments or inhaled treatments as opposed to another injection.
The dust/mold had cleared and with the cooler weather I've opened the windows to circulate the air, but I live in a densely populated neighborhood with lots of pollinating trees and plants year-round. Also, it's constantly "lawn care day" with the sound of lawnmowers, leaf blowers, and edgers 7 days a week. Not sure how much airing the house out accomplishes but I try to do it at night and not in the daytime.

Romeo was given Depo after his regimen of prednisone pills wasn't helping due to the fact he won't eat food with anything in it, and crushing the pills, mixing them with juice from his wet food, and putting them in a syringe made him puke 50% of the time. I wasn't sure how much he was actually getting. So after a glucose test showed it raised his levels only to 141, the vet said she was OK with giving him Depo to get rid of bronchitis going on three months thanks to other vets missing the diagnosis.

I know Depo works for several weeks so between that, the prednisone pills he did keep down, the Convenia shot, and the metronidazole, I can't imagine he'd still be sick.

UPDATE: Tested him again today, 24 hours after his injection. Did 4 strips because I know they can be weird. The results were 177, 73, 296 and 210. The vet agreed we should throw out the high and low ones and most likely he's between 177 and 210. She is OK with that but wants me to re-test on Monday, then Thursday, and do this for two weeks since that's the peak effectivity. He is only eating his low-carb wet food so there is no way he's that high from anything else from the meds. He isn't hitting the water bowl super hard or anything and seems to be OK in mood, if not a little reclusive sleeping in a private place. Then again, he's been sick for a while so I don't blame him.

Just praying he doesn't spike any higher and that it starts to drop off and stay down after the Depo wears off. He will NOT be getting another dose. This is just to help him kick this lower respiratory infection that's really got a hold of him after all this.
 
  • Thread Starter Thread Starter
  • #11

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
It may be time to ask for a referral to a specialist. Sometimes these complicated cases are too much for regular vets to handle.
Do you have Fluticazole as well as albuterol?
With the nebulizer, drugs are used as well as the saline, but you would need to talk to your vet sbout that.
I only have saline but between Romeo's recurrent FHV related respiratory stuff and the old cat Squeaky's severe asthma, I think in addition to his albuterol and Aerokat that I need some Fluticazole to add to the nebulizer...
 
  • Thread Starter Thread Starter
  • #12

FriendofFerals

Cat Mommy
Thread starter
Young Cat
Joined
Apr 29, 2018
Messages
93
Purraise
124
Location
Florida
I’d ask about fluticasone as well. Tessa uses it and it helps her a great deal. Are you in the USA? It can be very expensive. Our pharmacy thankfully accepts GoodRx for the cat, which helps reduce the cost by over half.
Everything is so expensive...the Albuterol is $70. Heck, they charged me $450 for an in-hours blood test--the one they messed up and caused me to seek out another vet. I'm unfortunately in a very expensive area and these vet clinics often take advantage of that as much as possible. I was paying $89 for a routine Depo shot for the old asthmatic cat. At the new vet yesterday with Romeo, the same shot is $28!
 

BeccaCat

TCS Member
Adult Cat
Joined
Dec 7, 2021
Messages
284
Purraise
552
Everything is so expensive...the Albuterol is $70. Heck, they charged me $450 for an in-hours blood test--the one they messed up and caused me to seek out another vet. I'm unfortunately in a very expensive area and these vet clinics often take advantage of that as much as possible. I was paying $89 for a routine Depo shot for the old asthmatic cat. At the new vet yesterday with Romeo, the same shot is $28!
I’m so glad you found a more affordable vet. Are you in the US near a Walgreens? Walgreens I get the albuterol for $30 with GoodRx.
 
Top