Lowest effective dose of Prednisolone for IBD cat

[saraandmaxi]

Hello - I am new here and this is my first post. My cat Max and I have been through the wringer these past 5-6 months. Despite a long history of digestive issues, we’ve had a vet who insisted on treating his inappetence as a dental issue. He had a dental procedure, the issue did not resolve. Ended up at the ER. They gave him urgent care wet food, which caused a severe IBD flare up. Ended up back at the ER two nights later and did an overnight hospital stay, where an ultrasound revealed thickening of the small intestine wall. His vet still insisted on treating it as a dental issue and recommended a second dental procedure. He had the second procedure and surprise, the issue did not resolve. She finally after 4 months of me begging and pleading that this was IBD, prescribed Prednisolone (transdermal because he is a terror about medication). We spent months suffering, him physically and me mentally having to see him in discomfort and pain, not to mention between all of the visits, meds, and special foods (none of which he liked), I’d estimate I’ve spent $10-11k.

Now that I’ve gotten the venting off my chest, I will say that he has responded well to Prednisolone and it feels like we finally have some stability back in our lives. It brings me so much joy to see my boy feeling well again. He turns 17 on Monday and if you would’ve asked me a couple months ago if I thought this birthday would come, I was worried he wouldn’t make it.

He has been on 5 mg a day for about 6 weeks. The vet has said I can try tapering to the lowest effective dose now. Last week, I tapered down to 2.5 mg for only three days and then bumped back up to 5 mg because I was afraid I was seeing a negative side effect. He was still eating enough, but a few nights in a row he seemed crabby and I would notice this little abdominal quiver, and it worried me he might be in pain. When I bumped back up to 5 mg, the quiver stopped. I don’t know if I didn’t give 2.5 mg enough of a chance because I am terrified to have him not feel well again or if it is truly possible to notice a negative difference in just a few days. In regard to the 5 mg dose, he has been doing super well on that and I haven’t noticed increase hunger, thirst, or urination, but I have noticed a slight curling of his ear tips, which I find worrisome because I’ve read that can be caused by steroid induced Cushing’s disease.

I’d like to have him on the lowest effective dose because I don’t want any negative side effects. Any advice or your experiences with this?

 

[saraandmaxi]

Edit: *Any advice or experiences with tapering down. Please no diet suggestions. He used to be on Royal Canin Fiber Response (for constipation), but he now rejects that and pretty much everything under the sun besides the one food he will eat now. Medication seems to be the only option at this point.

 

[stephanietx]

I have an IBD kitty and we've been in a flare since last June. It got better, but not completely gone. The lowest we've done is 5mg every other day. We get prednisolone treats from the vet. They work great for kitties who don't pill well.

 

[silent meowlook]

Hi. My cat was on Prednisolone 5 mg daily for over a year. I now have her at 5 mg every other day. You need to do whatever keeps him happy. There are risks with any drugs but there is more of a risk with constant inflammation. Prednisolone is better given at night.
You should also talk to your vet about vitamin B 12 injections as this is often low in cats with IBD.

 

[saraandmaxi]

I have an IBD kitty and we've been in a flare since last June. It got better, but not completely gone. The lowest we've done is 5mg every other day. We get prednisolone treats from the vet. They work great for kitties who don't pill well.

Thank you for the reply. I have read that even on Pred, they can still experience some flare ups. That makes sense because while he is doing a ton better, it’s not perfect. I still notice days where he seems like he’s dealing with some discomfort or pain. We actually did try chew treats first. He wouldn’t touch them. Transdermal appears to be the only form of med that he will tolerate. He’s my sassy old man.

 

[saraandmaxi]

Hi. My cat was on Prednisolone 5 mg daily for over a year. I now have her at 5 mg every other day. You need to do whatever keeps him happy. There are risks with any drugs but there is more of a risk with constant inflammation. Prednisolone is better given at night.
You should also talk to your vet about vitamin B 12 injections as this is often low in cats with IBD.

Thank you for the reply. That’s good to know he could be on 5 mg for longer term. The vet has said that she is ok with long term use at this point. It’s a chronic condition and there doesn’t appear to be any other way to handle it. I am currently giving his med around 3 pm each day because it feels like the easiest time of day to do it. He is usually napping at that time and is really tolerant when he’s sleepy. I would like to give it at night, but what do you do if you can’t be home every night? That is my dilemma. I live alone, so I’m the only one who can give him his med. I will ask his vet about B12 injections. I have read that a poor coat is a sign of poor B12 absorption. He does have a beautiful coat. Very soft and shiny, so I am not sure if he has malabsorption?

 

[silent meowlook]

Hi. 3pm is fine. It’s transdermal so it gets absorbed slower.