My cat has been on Prednisolone for almost 3 years, but now possibly steroid-induced Diabetes? ADVICE please!!!!

halle

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Hi there,
My cat is almost 8 years old and slightly overweight at ~15 pounds (but I swear most of that is his excess fur!). He was diagnosed a few years ago with IBD but we finally got it under control almost 3 years ago with 5mg of Prednisolone and a Royal Canin dry food diet of Pea Protein/Venison (which of course they're starting to discontinue). Also note: my cat will not touch wet food sadly.

My vet and I always shifted the Prednisolone dosage from 5mg every other day, to 2.5 mg the other day, etc. etc. except when IBD flare-ups would occur...then we would up the dose to 5mg everyday for about a week. This was the routine we were on for almost 2 years (with bloodwork checks every 6 months that were normal), until we added in Purina's Fortiflora Probiotic Powder to be sprinkled on top of his dry food 1x a day. With this addition, we were able to decrease to 5mg of Prednisolone every other day, and 2.5 mg on the other days for 11 months with no IBD flare-up. Then all of a sudden, with no warning my cat has another flare-up that seemed to go away very quickly by increasing the Pred again to 5mg every day, and even 7.5 on a couple of those days. However, after just a few days the flare-up came back, only this time he had increased thirst and urination so of course I got worried and brought him in. They tested his urine via urinalysis and it showed that he was "borderline diabetic." My vet said to immediately decrease the Pred to 2.5 mg for the next 3 days, and then decrease that to 2.5 mg every other day and see how my cat does. We are supposed to go back to the vet to have his urine re-tested in 2 weeks after being on this regimen - it is everyone's hope that it was the prolonged and increased use of the Prednisolone that caused him to show up as "borderline diabetic" and that by decreasing the steroids, he will hopefully go back to normal urine/glucose levels.

I am of course going out of my mind and am incredibly nervous for how these next 2 weeks will go and what will be - so I am desperately asking if anyone has been in this situation before with a potential "prednisolone-induced diabetic episode" or if you think my cat would have developed this anyway? Or does anyone have any advice for how to get a steroid-induced diabetes back in remission and fully recover?

Thank you so, so much for any and all advice! My cat and I really appreciate it.
 

tarasgirl06

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Hi there,
My cat is almost 8 years old and slightly overweight at ~15 pounds (but I swear most of that is his excess fur!). He was diagnosed a few years ago with IBD but we finally got it under control almost 3 years ago with 5mg of Prednisolone and a Royal Canin dry food diet of Pea Protein/Venison (which of course they're starting to discontinue). Also note: my cat will not touch wet food sadly.

My vet and I always shifted the Prednisolone dosage from 5mg every other day, to 2.5 mg the other day, etc. etc. except when IBD flare-ups would occur...then we would up the dose to 5mg everyday for about a week. This was the routine we were on for almost 2 years (with bloodwork checks every 6 months that were normal), until we added in Purina's Fortiflora Probiotic Powder to be sprinkled on top of his dry food 1x a day. With this addition, we were able to decrease to 5mg of Prednisolone every other day, and 2.5 mg on the other days for 11 months with no IBD flare-up. Then all of a sudden, with no warning my cat has another flare-up that seemed to go away very quickly by increasing the Pred again to 5mg every day, and even 7.5 on a couple of those days. However, after just a few days the flare-up came back, only this time he had increased thirst and urination so of course I got worried and brought him in. They tested his urine via urinalysis and it showed that he was "borderline diabetic." My vet said to immediately decrease the Pred to 2.5 mg for the next 3 days, and then decrease that to 2.5 mg every other day and see how my cat does. We are supposed to go back to the vet to have his urine re-tested in 2 weeks after being on this regimen - it is everyone's hope that it was the prolonged and increased use of the Prednisolone that caused him to show up as "borderline diabetic" and that by decreasing the steroids, he will hopefully go back to normal urine/glucose levels.

I am of course going out of my mind and am incredibly nervous for how these next 2 weeks will go and what will be - so I am desperately asking if anyone has been in this situation before with a potential "prednisolone-induced diabetic episode" or if you think my cat would have developed this anyway? Or does anyone have any advice for how to get a steroid-induced diabetes back in remission and fully recover?

Thank you so, so much for any and all advice! My cat and I really appreciate it.
Hello H halle and sweet cat, and welcome to TCS! Though I do not have experience of this and so I can't offer advice beyond following the vet's protocol, I am hoping that others who may be able to help will post quickly. My best thoughts and *PRAYERS* for your cat! and hoping you'll keep us informed as to his progress.
 

LTS3

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Diabetes isn't the end of the world. It is very treatable with insulin and diet. A cat with both IBD and diabetes can live a long healthy life if both conditions are treated and managed.

A glucose test via urine isn't all that accurate. Glucose collects in the bladder until the cat pees. Excess glucose will cause a high reading. A fructosamine blood test is more accurate of what your cat's blood glucose level is. It's kind of like an AC1 test for Human diabetics. You can also test your cat's blood glucose levels at home. I do that sometimes with my IBD cat who tends to have diabetic-like symptoms when he's on a high dose of pred.

Since your cat won't eat canned food, which is best for the diabetes, lowering the blood glucose levels to normal healthy levels might not be possible. Dry foods are full of carbs which causes blood glucose levels to be high. Raw and home cooked diets are an option but not everyone wants / can feed those for various reasons. You may want to ask on the FelineDiabetes.com message board for more advice. There are cats there who developed diabetes after being on a high dose of pred for another health issue.
 

tyleete

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What LTS3 said!
Most dry foods are loaded in carbs. My diabetic kitty wasn't ever on Pred or overweight, but developed it all the same. Her numbers were very low 300's. Vet had me give low dosage of insulin first month with diet change, then even lower amount another 2-4 weeks. Think it was 4. Her next curve proved she went into remission, so no more insulin.
She'll forever be on a specialty (diabetes is one of the most expensive of specialty foods to but) diet, but about a year later, her numbers are perfect!
She eats both wet and dry.
Wet- Fancy Feast classic plates, just no fish, or the original Friskies pates.
Dry- Purina Pro plan DM. Can be found here: PURINA PRO PLAN VETERINARY DIETS DM Dietetic Management Feline Formula Dry Cat Food, 3.5-lb bag - Chewy.com
As forthe IBD thing? I've 2 cats with it and have tried so many different things. Steroids would work only so long and I worried about exactly what has happened in your situation. There's 2 possible ways to help without Rx's.
1- cbd tinctures help animals in a lot of different ways. It helped one of my IBD kitties for a while, but the effects would wane and wasn't worth the fight to get her to take it. But it has helped many others. It helps by working as an anti-inflammatory. Especially in the guy region. Also helps with naseau too.
Neither of mine are on that now, but my Cancer kitty has been for well over a year. She had to take Pred every night not to throw up daily. She takes a tying amount twice a day and rarely ever throws up now. Also helps her arthritis too as she's almost 18.
2 way, which both IBD cats have been doing for a few months with amazing results, is pureed chicken & water.
When one of mine don't feel well and don't want to eat, they will get some Beechnut Stage 1 chicken baby food. It seems to encourage them to eat as well as helps get them past rough patches.
My one girl needed this, and was sure a shot (she'd take a monthly one that's essentially Methylprednisolone) & suddenly started having normal poop!
Got to a few days, then weeks, then months. I was giving her half a baby jar twice a day (plus regular food), but had to cut back because her stool was looking a little TOO dried out. Something I never thought I'd say for her. Now I'm also just baking the chicken myself, tossing it in the ninja, adding water and freezing it. She gets 1/2 a jar once a day. And It's been months without any steroids. She'll still throw up once every week or two. But no wet stool. It's been so amazing after years of trying everything. I just had to get her off the steroids. As it happens, the IBD one is the mother of the one with diabetes. So I really wanted her off that. My not who also has had IBD since at least I took him in has alsobeen doing great with rarely a semi-wet poop. But he gets half a jar twice a day.
As for testing at home for glucose levels? It's the best. 1- glucose curve tests aren't cheap and you leave the kitty there all day. 2- know what also raises their test results? Stress.😄
So their levels can be higher while at the vets office than at home. I bought a pet glucose meter called Advocate pet meter. It's real simple to use and no longer expensive.
Last bit (sorry so long), try this for yippy cat's dietary needs. It has all these cat foods and the levels you'll need to know for your forensi diabetic baby. I think it's on the shelf food, not Rx foods. But had helped me a lot. From what I understand, under 10 carbs is best. The lower the better. But can go 14. It's even got drop down menus to help.
Best of luck!💗
 

tyleete

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Forgot something. My diabetic cat was just in the vets and said normally she'd give steroids to help an issue she was having. But "You don't give steroids to a diabetic". So you might ask again if you shouldn't drop the Pred asap. I don't know why exactly a diabetic shouldn't have steroids, but that's what she told me.
 
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halle

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This is all incredibly helpful information everyone, thank you so much! Part of my cat's issue with IBD is that he can not have ANY food with chicken. That is a clear trigger for him. So I'm wondering (once we get his glucose levels re-tested in about 10 days) what food I should switch him to that is as close as possible to his current dry food diet of Royal Canin PV (pea protein/venison) but perhaps a wet food version? (Note: All of Royal Canin & Hill's wet food versions of this food are completely sold out and manufacturing is paused due to supply chain issues. Just awful).
Like I said, he historically simply would not touch wet food, but I may try to re-introduce it again by adding a bit of probiotic powder on top. The only "treat" he's also been able to tolerate is pumpkin puree, so maybe adding some of that on top of a new wet food could be a good way to entice him to eat it?
 

Sajast

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This is all incredibly helpful information everyone, thank you so much! Part of my cat's issue with IBD is that he can not have ANY food with chicken. That is a clear trigger for him. So I'm wondering (once we get his glucose levels re-tested in about 10 days) what food I should switch him to that is as close as possible to his current dry food diet of Royal Canin PV (pea protein/venison) but perhaps a wet food version? (Note: All of Royal Canin & Hill's wet food versions of this food are completely sold out and manufacturing is paused due to supply chain issues. Just awful).
Like I said, he historically simply would not touch wet food, but I may try to re-introduce it again by adding a bit of probiotic powder on top. The only "treat" he's also been able to tolerate is pumpkin puree, so maybe adding some of that on top of a new wet food could be a good way to entice him to eat it?
There are Hydrolyzed formulas now for IBD/food allergy cats that might be worth a try. Royal Canin makes a prescription hydrolyzed protein diet.The primary protein source is soy with some chicken fat but it’s hydrolyzed so their immune system can’t recognize and therefore won’t react to the protein. My girl has eosinophilic IBD (aka food allergies) and I haven’t found a single novel protein she can eat - no duck, venison, rabbit, boar, or even alligator and the standard proteins (chicken, turkey, fish, etc) are an absolute no. But the Royal Canin Hydrolyzed keeps her in pretty good shape minus a couple of mild flare ups, so no prednisone.

ETA: Royal Canin does not make a wet food version of their hydrolyzed formula but Hill’s has Z/D which is also hydrolyzed. The consistency of the wet food, however, may not work well with a finicky cat. It’s weirdly gummy and thick.
 

LTS3

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If it has to be dry food, I suggest a commercially available novel protein brand such as these:

BLUE Basics® Limited Ingredient Cat Food | Blue Buffalo
Limited Ingredient Diet - Grain Free Cat | Merrick Pet Care
Instinct Limited Ingredient Diet | Instinct Pet Food
Minimally Processed Natural Cat Food Archives | RAWZ

Most have a canned food version available.

Another canned food only brand to try is Fresh & Natural Cat Food - Hound & Gatos

Have you tried different textures of canned food in the past? Some cats will only eat chunks / shreds / slices in gravy / sauce. Others will only eat pate.

Try rabbit or other protein. Double check the ingredients to be sure there isn't chicken of any sort listed. I'd limit seafood of any kind because too much is not good in general for all cats. Some IBD cats are sensitive to all poultry. I recently found out my IBD cat who has a known sensitivity to chicken can no longer eat turkey.

For food toppers, try crushed up freeze dried meat or fish treats. Pure Bites is one brand but there are many others. FortiFlora works well, too, to get cats to try new food but use that sparingly. Some cats get addicted to FortiFlora and will not eat unless the food has a sprinkle of the stuff on top :rolleyes:
 

tarasgirl06

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Dried bonito flakes are very popular with my clowder over the years. You can get these throughy petco.com or probably just about any "pet" supply venue. Sprinkled on wet food, they are a big draw.
 
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