Experiences With Prednisolone For Ibd?

[munch64]

Hi Friends,

I have posted here in the past about my sweet Siamese Gwennie who sadly crossed the rainbow bridge in April of this year. Our other cat, 12.5 year old orange tabby Farley, is having some trouble, so I am interested in hearing some experiences of prednisolone.

How long does it usually take for prednisolone to work on diarrhea when a cat has IBD? Should he have been showing improvement by now?

My 12.5 year old cat Farley has been taking 15mg pred divided in two doses for 11 days now and while his appetite is back to normal and he's put a bit of weight back on, he is still having liquidy LOUD diarrhea. Like he sounds like a mostly empty ketchup squeeze bottle. About 30-40% of the time, he diarrheas on the floor. And there are 3 litterboxes distributed in our apartment for him to use. So he clearly doesn't have time to do much when the urge hits. It breaks my heart. He's been having problems with diarrhea since mid-August and we have run lots of tests on him and gotten an ultrasound.

I will of course discuss this further with the vet at his re-check, but I always appreciate hearing stories and experiences of folks on this site. You all are really kind and helpful and I have used this site as a resource for helping me to formulate questions to ask the vet.

Other info to know: I have been giving him a Proviable probiotic each morning in his wet food. Briefly, before we even started the pred, Proviable had seemed to help firm up his stool. But it doesn't seem to be helping now. I had to change his wet food because he was being finicky with his usual wet food and wouldn't eat it -- this could possibly be part of the issue. But he is still getting familiar kibble, so it wasn't a 100% food change. He is a catnip-aholic and I have since realized that I may have been letting him have too much. I'm seeing online that it can cause vomiting or diarrhea in cats. He begs for it when his tummy is upset. Ironically.

His thyroid is fine, B12 and folate levels are fine. Vet broached the subject that it could be small cell lymphoma.

Farley also has mild chronic kidney disease, a heart murmur, and mild asthma.

And he is the sweetest, cutest, friendliest, cuddliest cat in the whole world. We really adore him. Thank you for any insight you can share.

 

[mrsgreenjeens]

I don't have any personal experience with IBD, but just in case no one responds, here is a link to IBD that may prove useful to you: IBDKitties – Helping Save Lives…One Paw at a Time

I would have thought that if it were going to work, the pred would have already started doing it's thing by now. BTW, even if it's small cell lymphoma, pred is usually given, along with Leukeran, which is sometimes also given for IBD if all else fails. And, IF it turns out to be small cell lymphoma, that's the easiest to treat, really. Normally the cats don't have any bad reaction to the meds. It's not like chemo for large cell, and definitely not like for humans. But from what I've read, DRY food is terrible for IBD cats, so that may be what is contributing to the continuing diarrhea. Either way though, I would definitely let the Vet know (via phone call), that the pred doesn't seem to be stopping his issue. I wouldn't wait for his follow-up unless it's tomorrow

 

[LTS3]

Pred worked well for my IBD cat. Diarrhea wasn't one of his main symptoms although he did have a few episodes early on which was triggered by a sensitivity to chicken.

With any medicine, you must have patience 11 days may seem like a long time but it may take longer than that to help some IBD cats. Additional medicines may be needed. Leroy was on 5 different ones at one point.

Proviable is ok but there are better ones out there. I use a 50 billion CFU Human probiotic for Leroy. I also give him S. boulardii, another probiotic.

What brand of food are you feeding? A limited ingredient type novel protein is helpful. The blander the food the better is seems for IBD cats and their sensitive tummies.

 

[daftcat75]

Did you check for EPI (Exocrine Pancreatic Insufficiency)? The test is fTLI.

Has he ever been stable on this food?

Dry food is terrible for cats with digestive problems. Because it is high carbs, it empties from the stomach with too high pH for the digestive enzymes and bile in the small intestine to be effective. It could be contributing to, if not causing the diarrhea.

For relief, you can add pumpkin (about 1 tsp to start) to his food. Puréed pumpkin. No other ingredients. But I suspect this is a little too big a problem for pumpkin alone.

Vitality Science has supplements that will help clear up his diarrhea if you’re certain it’s not the food or EPI causing it. They have excellent customer service so you could call them or drop them an email (they usually respond within a day) to see what they recommend. I would go with Lithothanium to dry up his stools but you should ask them.
Lithothamnium, Sea Calcium Supplement for Cats | Vitality Science

 

[munch64]

Thank you for the replies!

The pred HAS helped his vomiting. Which I realize now I did not mention before. He was vomiting about every other day. So I'm very grateful for that.

He has not ever been stable on this food. There really isn't any food he's been stable on since this started in August. I was feeding him primarily Soulistic wet foods that were low in phosphorus for his kidneys. (He rejected all the kidney diet prescription foods the vet sold me, so Soulistic was our compromise choice.) He was not eating much kibble from February till I started him on the pred. He didn't want it most of the time.

And then he had a bout of what the vet thought was mild pancreatitis in June (positive on the quick pancreas test, which is not definitive though). He became very finicky and we had to constantly encourage him to eat. Cerenia and/or famotidine sometimes helped his appetite, but not consistently. But once he was on the pred, he was very hungry (which is a known side effect) but even then still refusing to eat his Soulistic wet food. He'd only eat some kibble then. Worried that his diarrhea and vomiting was due at least in part to food intolerances, I decided to start slowly introducing non-prescription limited ingredient diets to him. The vets I consulted are pretty useless when it comes to discussing diet. But that is a whole other story. He went crazy for the new food! Merrick LID Duck pate and Merrick LID turkey kibble. Both of them are relatively low in phosphorus, so comparable to his Soulistic foods. I mixed the turkey kibble with his other kibble and hope to slowly reduce those to nothing.

He had lost a lot of weight through this illness, and by eating these foods, he's putting some weight back on. But the liquidy diarrhea remains.

I stopped giving him catnip and I'm watching to see if he does any better in a few days with that out of his diet. He doesn't just roll in it like other cats, he eats it. And then he'll repetitively lick the floor later where the catnip was.

He won't eat anything with pumpkin in it. And no, the vets haven't checked him pancreatic insufficiency. He did just have the full pancreatitis test that goes to Texas A&M and the result was 6.

Before things got too bad, back in early August, the vet had given Proviable as an option to firm up his stool. I was to give that along with metronidazole. They did fecal tests, and those were negative. The metronidazole didn't help his stool, but the Proviable I kept giving after the metronidazole course was finished did seem to have a firming effect. But unfortunately on days I gave it, he'd vomit. Then he'd flare with diarrhea.

The ultrasound he had mid October showed thickening of the intestines and enlarged lymph nodes. The ultrasound doctor did a needle aspiration of a lymph node in his neck and it came back negative. That doctor had actually expressed confidence during the ultrasound that Farley has large cell lymphoma, but the internist I took him to to ask about doing an endoscopy said he really didn't think it was large cell. And we didn't do the endoscopy because the scope would not have reached the section of the intestines that was enlarged and the scope samples are pretty shallow anyway. Internist said if the pred doesn't ultimately work, we will try Leukeran.

Throughout all of this, I will say that he's not acting lethargic. He jogs alongside me when I'm going to prepare a plate of his Merrick wet food. He's moving around, asking for cuddles, following me, being adorable. In fact, he just jumped on the couch and laid on my lap when I was about halfway through writing this. <3

 

[daftcat75]

Thanks for all that.

EPI may still be on the table even if pancreatitis is not. That he's able to gain weight though, maybe not the issue.

Vitality Science could still help with a probiotic. They could also help with the diarrhea.

You may have to keep working the foods until you find one he's stable on. Start a food journal if you don't have one already. What you gave, when you gave it, how much he ate, and did he have a reaction. Also note any medications. An elimination diet may also be necessary.

I don't have experience with pred or leukeran.

 

[munch64]

daftcat75 Thanks, I will definitely ask about EPI. It does sound like it could be affecting him.

 

[doomsdave]

What's IBD?

Der Baron von Komfy had an allergic reaction which prompted the vet to give him prednisone for a while, which got him happy (and hairy) again. (He was starting to lose hair.)

He's not on prednisone any more, and he's about senior age now. Still comfy, as always.

Oops, I think it's Inflammatory Bowel Disease. Definitely not the Baron's problem. (Thank god!)

IMG_2201.JPG

• doomsdave
• Mar 21, 2017
• 2

 

[munch64]

I'm glad Baron von Komfy is feeling better! He's gorgeous.

Yes, IBD is pretty awful. There are different ways it presents--sometimes with more vomiting, sometimes with more diarrhea, and sometimes it's a mix. Farley's is definitely diarrhea heavy.

He just ate wet food, and now his abdomen is making gurgling sounds so loud that I can hear them from 12 feet away. He's laying like a meat loaf. Poor guy. I keep puppy piddle pads handy around the apartment in case he has an urgent attack and won't make it to the litterbox, and if I can, I hold one under him while he goes.

His recheck is in a week. I left a message yesterday morning with the vet that his diarrhea has not improved despite 15mg of pred per day. As if this evening, he has not returned my call.

 

[jen]

Worked well with my old cat Kinks too. She had IBD or GI Lymphoma. On Pred the last 6ish months of her life, along with a limited ingredient canned food and slippery elm bark as well. Honestly things were SO much better with the slippery elm added in.

 

[munch64]

Posting an update on Farley. He does not have EPI. The vet did test for that, but hadn't explained it. He's continued taking pred twice daily (15mg total per day) and we did 4 doses of chlorambucil liquid compounded flavored meds with him. I believe the dose was 2mg every three days. He didn't tolerate it very well. The first dose was ok, but he got progressively more sickly with each dose and his diarrhea didn't improve at all. I took him to the regular vet one week ago (2ish weeks after starting it) to discuss chlorambucil, do a blood test to make sure he's not getting anemic, and also talked to the fancy internist about it and we decided to take him off of it and give him a break. I also noticed that his diarrhea got very dark in color (almost black) and the regular vet suspects he has a bleeding ulcer somewhere. So she prescribed sucralfate for him--this is supposed to help coat the lining of the digestive tract to help an ulcer heal. It helps, but since I have to give it separately from other meds, it's been difficult to give it to him. Regular vet also gave him quarter tablet of mirtazapine... Yikes. He was meowing lots, acting drunk, crawling all over us, stumbling. I got up five times during the night to tend to him. She sent mirtazapine home with me and I've since discovered that mixing a tiny crumb of it (like 1/32 of a tablet) in with his pred each evening is just right. Stimulates appetite but doesn't make him frantic. It's a wonder drug for him. He doesn't want to eat without it anymore. Even though he's getting cerenia for five days and off for a day. :'(

So...he's not doing great. Only feels well when he's very medicated. And I have noticed today that he's not doing much grooming anymore. He used to be so meticulous. Still cuddling (laying on my lap as I type this) and can still climb on his perch and use his litterbox, but he's deteriorating.

Last note: I had success using slippery elm syrup for excess stomach acid with my beloved girl Gwennie who crossed the rainbow bridge in April. Farley takes it just fine, but he inevitably vomits later on the days I give it. I think I will stop giving it. Maybe he's sensitive to it somehow.