Prednisolone doesn't increase eating? Advice wanted

[nevroth]

TL;DR - 

My plea for your experiences is this:

What were your cat's side effects on prednisolone? Do you think the power of the medication should overwrite "Ew I'm not eating THAT again!" mentality? Or nausea?

Can a cat be nauseous without vomiting?

Have you had a cat get an endoscopy to "get it over with" to see if she has lymphoma or try other tactics? And what would those tactics even be?

Slightly expanded -

Meph has been on 5mg prednisolone for 3.5wks now for suspected IBD. Overall her mood has vastly improved; no more hiding, she's playing a bit more and venturing out of the bedroom again. She's even being affectionate!

BUT! Her appetite continues to be poor. In fact she lost another 0.5lb (from 8.5lb to 8lb, down 1lb since New Years). I'm trying to figure out what foods she'll eat, as she's being quite picky at the moment, but the vet said the pred would increase her appetite and as such most cats gain weight. That hasn't happened. In fact, the vet doesn't want to continue her on the pred as "it isn't working" and strongly recommends I get an endoscopy as he thinks it may be lymphoma. I give her about 5oz of wet food daily (duck or seafood varieties) and 1 to 1.5oz of dry (duck/pea) but she won't eat all of it. I just started tracking her calories and she's getting maaaaybe 100kcal/daily. Methinks she should get at least 160kcal to maintain 8lbs (the vet said she was 'slightly chubby' at 8.5 so I guess 8lbs is good?) Just bought some stella & chewy today to give that a shot. I've been giving her pumpkin (now on day 4) because she was constipated a week ago but she's getting diarrhea now, could it be the pumpkin or trying different foods?

This is the 2nd I've taken her too. He's going off of one visit and her records. I don't know if I'm being unreasonable, but I would have liked another evaluation (maybe more updated blood work?) - but she's feeling so much better I'd hate to take her to the vet unnecessarily. I was in shock from talking to the vet (via phone) about his concern it could be lymphoma, so I forgot to say that even though she's not vomiting, she's licking her lips a lot and goes to the food then turns away (signs of nausea?). I've heard of B12 shots and sub q's, but I don't even know how to ask the vet as he told me "I don't want to give her any medication and waste time, because too much time wasted is really bad." I've got a list of specialists to call on Monday for quotes.

Had my first panic attack in 3yrs today.... EAT MEPH, PLZ EAT!!!! 

 

 

[merlotandasti]

Sorry that I can't be of any help or give any advice. I'll be praying for you & Meph!!! I hope her appetite boosts really really soon & that you're able to get answers (good answers)!!

 

[stephenq]

 

Hi my cat battled severe IBD for 15+ months and Prednisolone helped him a lot.  There were no negative side effects and generally the only side effects in cats (besides feeling better and being better) is a risk down the road for diabetes and a decreased immune system, both acceptable risks when a cat has severe IBD.

To answer your other question, YES a cat can feel nauseous without vomiting, and often cats with long term issues like this get treated with Cerenia, a miracle anti-nausea drug.  It's a neural blocker for nausea and my cat was on it daily for over 15 months.  The label says you should take them off it once every 5 days for a "rest" but many vets are recognizing that a lot of cats at a reasonable dose can tolerate it 7 days a week.  I would discuss Cerenia with your vet.

A biopsy whether surgical or endoscopic (upper GI if that's where they suspect her problem is, lower GI is diarrhea as a rule, and upper GI is vomiting but thats just a rough take on it) CANNOT be done while a cat is on steroids, the results are likely meaningless as the pred masks the problem, so your cat would have to be off the pred for a period of time before they went inside her.  Given that it doesn't seem to be working that may be a good plan, but if its small cell lymphoma then the drug of choice is Leukeran (chlorambucil) and many vets will prescribe this without a biopsy on suspician of lymphoma as a) its generally well tolerated and b) there really is no other drug to use at this

point so I would discuss that with your vet as well.  If your cat doesn't tolerate the Leukeran (vomiting) you'll know it fairly quickly and may have to take her off it.

What is her Pred dose?

Other therapies that can help is Zofran injectable, another type of anti-nausea drug that can be used with Cerenia but has to go in every 6 hours but a dose given sub q with fluids and injectable

pepcid can jump start a cat to eat.

I agree that your cat's continuing to lose weight is not a good thing and I hope you can turn it around soon.

 

[babiesmom5]

I can empathize with you having dealt with the IBD and Lymphoma issue with 4 cats.  Prednisolone will increase the appetite, but oftentimes the nausea issue prevails.  So an anti-nausea med like Cerenia is usually prescribed in addition for use as needed.  Your cat who is licking lips, sniffing food then walking away is probably nauseous.  They don't have to vomit to be nauseous.  They will sometimes drink water when nauseous also.  An appetite stimulant like Mirtazapine is often prescribed also, especially in the beginning to boost appetite and get the weight up.  However, bear in mind that most cats with IBD/Lymphoma develop "flavor fatigue"; it is a hallmark of the disease.  You need to have many different flavors on hand and accept that they will tire of flavors rapidly.  To outfox them, you need to be able to switch flavors as necessary.  Accept the fact that you may have many open cans and have to throw some out.  Still, switching flavors may decrease the need for appetite stimulants.

As an example, I currently have two sister cats, 15 years old, recently diagnosed with mild IBD.  I was very proactive with these two cats after their brother had bad IBD and their sister's developed into Lymphoma (now both deceased).

Both sister cats started out with morning nausea, occasionally vomiting bile/foam, decreased appetite and slight weight loss.  First step after local Vet exam was GI Ultrasound which showed mild thickening of the small intestine.  Next step was upper GI endoscopy.  Fortunately, for both cats biopsy showed mild IBD.

While awaiting biopsy results, both cats were then put on a steroid.  The one cat is on 5 mg Prednisolone in AM and in evening 1/2 a pill (2 1/2mg) for a daily total of 7 1/2 mg Prednisolone.  Her appetite has increased and she has gained weight, but she still needs 1/4 Mirtazapine to boost appetite maybe once a week and Cerenia maybe once a week also if needed.  She is doing very well at present.

Her sister who only recently had endoscopy on Feb 13, is on 8 mg Methylprednisolone--4 mg AM, 4 mg PM.  While the steroid has increased the appetite some, Vet suggested  giving 1/8 Mirtazapine occasionally, which in her case just one made her ravenous and has kept her going.  She has gained weight and is doing quite well now.  Vet said her steroid will likely be scaled back in near future once stabilized.

In your case, your cat was put on Prednisolone first, which if an Endoscopy is done now, the Prednisolone would likely mask possible Lymphoma, unless the cat was taken off Prednisolone for a period of 6 weeks.  Normally, Vets wait  until all diagnostic tests, (Ultrasound and Endoscopy) are done to rule out or rule in Lymphoma, before starting the cat on a steroid.  At this point, since the 5 mg Prednisolone  alone is not working (without adjunct of anti-nausea meds and/or appetite stimulants), and cat is still losing weight, it may be more advanced IBD or Lymphoma.  I think you need to get some answers ASAP.

If I were in your shoes right now, I would seek out a good Vet specializing in Internal Medicine.  They are usually located or affiliated with Veterinary Schools, comprehensive and specialty hospitals in major metropolitan areas. 

I hope you will take this for what it is worth.  I am not a Vet, but have learned a lot the hard way (sadly) with beloved cats with IBD and Lymphoma.  Hope some will be of help to you.  Good Luck!

 

[artiemom]

You have been given some great advise by great people.. 

From my understanding, which could be wrong, the steroid is to help decrease the inflammation of the colon. A side effect of any steroid is increased appetite--even in humans. 

If your cat is going over to the food and turning away, lip-licking, then I would think an anti-nausea medication is appropriate. Something like Cerenia or Zofran. These work on the stimulus from the brain.

If you cat is not eating, there could also be a build up of gastric acid in her stomach also. Pepcid would help with that. The Cerenia also has a pain relieving side effect also. 

And the last thing to ask for is an appetite stimulant-- to jump start her eating. 

I know it sounds like a lot, and I have been there and still are there.. @StephenQ  has been wonderful with his advice/knowledge. I learned most of this from him... and it is trial and error to find the right mix of things..

It seems most cats with IBD are fussy. They seem to get a 'food intolerance", meaning that they will avoid the food which the ate when they were sick. That is why they are fussy. 

Sometimes fluids can be helpful... but are done mostly to keep you cat hydrated.. by keeping them hydrated, they feel better, hence their appetite improves. They are also given to avoid dehydration, which I can come from not eating, drinking.. 

These are things you need to go over with a trusted Vet.. I really think you need to find either a local vet who feels they can handle IBD, or find an Internal Medicine Vet who has experience with IBD/Lymphoma; they can advise you best. 

By starting your cat immediately on a steroid, that really hinders having biopsy. You would have to stop the steroid for a period of time.. before undergoing the biopsy. In other words, you would have to make you cat return to their pre-steroid condition,  in order to have the biopsy-- not something many people would do.

From what I understand, the treatment for severe IBD/lymphoma is not different except for the addition of the chemo drug.. and some Internal Medicine Vets/ Vets, will still prescribe the chemo, even in the absence of a biopsy. 

I know this is confusing.. I hope I did not add to your confusion.. and I sincerely hope I am explaining things appropriately..

Good Luck!

 

[nevroth]

Thank you so much @MerlotandAsti, @StephenQ, @babiesmom5, @Artiemom

I've sent an email to the vet about how long she needs to be off steroids before an endoscopy can be done . He did tell me that usually an endoscopy is done first because the steroids can mask the inflammation, but the sticker shock ($2500) and the chance she could get better without it were the reasons why I chose to go with prednisolone first.

I also asked about the nausea because I'm a low confidence ding-dong and didn't want to say straight out, 'what about cerenia or other anti-nausea drugs?' My boyfriend scolded me yesterday (he has a funny way of comforting sometimes!) about my willingness to try too many different things at once. Haha, we're both scientists, I should know that. But the heart overrides the head sometimes...

I have mirtazapine on hand from her last vet. This vet didn't want me to give it to her because "if she's not eating then something is wrong and we don't want to hide that in case it gets worse." Which is a good mentality I agreed with. But I have it. I stare at it sometimes. A lot more now actually.

She's getting 5mg pred/daily. Though she only has 4 days of it left (including today). I haven't given it yet. I feel like I should try a quick and dirty wean off process then have her go cold turkey. Just need to think about every other day or 2.5mg/daily. Yes I know this means I'll have to put off the endoscopy a little more, but... ... there's always buts. that's my problem; there's always something more I want to do...

I'm in disbelief because on one hand she does seem better. So much better. Sundays are weigh days and she didn't want to lay still on the scale so I'll post how much she weighs in this evening. Yesterday (For her journal, days start/ end at 8AM) she ate ALL of a soulistic tri-fusion flavor. Though I'm skeptical of the beef included, it was something 'different' I had on hand. At least I know it was 125kcal! A little kibble was nibbled at too. I hope it was the weather and not the beef last time that gave her constipation. Though the litterbox was suspiciously free of poo presents today...

I'm also taking this hard because I lost my mum to cancer when I was just starting college. I felt so helpless. There was nothing I could do. Now at least, there's something I CAN DO, but feel tossed back in those sad, scary days. I think even for my peace of mind I will do the endoscopy (hey that's what credit cards are for right? must keep repeating that mantra....) Hopefully she doesn't have to suffer too long before it can be done (or maybe she'll be a-ok!! I can think positively right?)

Thank you for sharing your stories. I feel like a super ding-dong that I should have just had the endoscopy done immediately (oh but she was SOOO MISERABLE a few weeks ago, being put through that....). I have the feeling this vet will work with me if I choose not to have it done, but would rather I get it done to get a better diagnosis (he also warned me that the endoscopy could show up nothing, which means IBD).

This vet did give me a list of specialists to choose from; they're all pretty far from me (haha, in Los Angeles "local" can be either walking distance or 30mi away. But the traffic makes even 10mi trips a hour sometimes...) and I see one is 24hr so I'll give them a call right now. I've already missed my ballet class (but gotta get to rehearsal at 11:30!) so I may as well be productive....

Thank you, thank you again. My work-bestie got laid off two fridays ago and she was the one I vented a lot of this to (of course I'm nervous about my job security but that's a whole other thing). My boyfriend will hear it but he has a dog with end-stage cancer so I feel bad talking about this to him (especially because he "sees" her improving and thinks (rightly so?) that I'm helicopter-mom-ing. Momo is a great listener but only snuggles on his schedule (brat lol).

 

[cindycrna]

My Leonard has FIP and is on an immune booster to help combat it but the nausea is persistent. He gets 4mg of Cerenia, 4mg of Zofran and 1/4 of a Pepcid AC and we still can't get ahead of the nausea. Like your kitty, he goes to the dish, hovers then walks away. We have tried every food known to man from Meow Mix to Orijen. He is syringe fed as we try to get thru this. He has never thrown up so yes they can have persistent nausea with vomiting.

 

[stephenq]

 
Thank you so much @MerlotandAsti, @StephenQ, @babiesmom5, @Artiemom

Mirtazapine is a odd drug, the appetite stimulant is a side effect, I would only use it if i was desperate for various reasons some of which you stated yourself.  I'd try to combat the nausea first, again in serious situations my vet does a Sub Q cocktail with fluids, cerenia, zofran and pepcid (and B12).  It can do wonders.

Do note that weight loss from IBD or SCL can happen even when theyre eating as the inflammation of the intestines prevents nutrients from being absorbed.  This is why its critical to get it into remission, or the prognosis is poor.  Also note that biopsies by whatever method do not always yield conclusive results.  Adding leukeran to the prednisolone could be very helpful and much cheaper along with the anti nausea drugs.  Haqve you done an ultrasound?  Is the vet confident that the problem is upper GI and not lower GI?  And endoscopy can only biopsy upper GI.

 

[Brian007]

Catnip is an excellent appetite stimulant, reduces stomach acid, treats nausea, and is a general digestive aid, as well as a stress-reducer. Try leaving some high quality powdered catnip in a bowl next to her food bowl.  She should then self-regulate her intake, as and when needed.  

How much pumpkin are you giving her?  It has the double action of treating both constipation and diarrhoea, so reduce the amount until you reach a balance.  

Egg yolk is pretty appetising, high in calories, and jam-packed with essential nutrients and amino acids.  Only the yolk though, not the white.  Cheese is yumptious too.  You could try a cheese and egg yolk scramble, if she won't eat, I will.

Tuna water is also tasty and could lead onto tuna eating.  Sardines are also enticingly stinky 

Vitamin B 12 is an appetite stimulant.  I guess you could ask your vet about the best method to administer, but you could easily crumble a shop bought tablet if your vet thought it ok.  It would be considerably cheaper than a vet visit and injection.  Dudley loves Marmite, as do I, which is rammed with vitamin B, but I'm not recommending it per say, merely mentioning it in passing, in a conversational way.

Do you hang out with her when she eats/attempts to eat?  She'd probably appreciate some company and hand feeding.  General cuddling and stroking throughout the day should boost her serotonin levels, which would increase appetite. 

 That's basically what mirtazapine does.  I'd think about giving her the tablet you're eyeing, if all else fails.  One of my mum's cats took it with immediate results, gobble.

Also, between cuddles, you could try some light exercise with a wand to try work up an appetite.   

  Massaging gently can also stimulate the stomach juices to flow.

As well as offering her a wide range in taste of commercial cat food, also offer a range in texture.  Warming up to "mouse-blood" temperature in the microwave for a few seconds will also increase the aroma and may it more appetising.  Baby food is also agreeable to cats, just make sure it doesn't contain onion. 

Do you have Dreamies where you are?  Virtually all British cats are addicted to them.  They're a dangerously scrumdelicous treat.

Try psychological trickery, by holding her food up your mouth and softly meow, smack your lips, and generally get all excited about it, to try to pique her curiosity.  

Is it warm where you are?  Warming her body temperature up may help her feel more hungry.

Red clover is safe for cats and it basically eats cancer, just saying, out of interest, not recommending.  

 

Omega-3 oil found in fish oil, especially pure in krill oil, also helps fight the brave fight.  

If she has to go on long car journeys to the vet specialist, valerian is very useful for chillaxing.  I'd check with your vet first though as you wouldn't want it to interfere with her test.  Bach Flower Rescue Remedy, also.

What ballet are you rehearsing?   I like the ballet 

You've probably heard lots of this advice before but I figure I might as well post it in case there's the odd top tip.  And it may benefit others who read your thread also.  

Your mum would be ever so proud of you  

Sorry that I've not actually answered any of your questions and suggested supplementaries instead.  I'd try the catnip first  

 

[nevroth]

Thank you @CindyCRNA,

@StephenQ

@Brian007

My vet didn't want to do an ultrasound without the endoscopy because "the results are still inconclusive and they would still recommend an endoscopy."

Meph gets 1/2 tbsp pumpkin mixed with a little water nightly. 

The good news, yesterday Meph weighed 3.65kg. On 2/26/17 she weighed 3.63kg, so not a big difference! She also left good presents for me in the litterbox and ate about 175kcal!! This morning she wasn't in my room at all but running around the living room when I went looking for her

My boyfriend really pulled through for me yesterday. Calming me down, going through all my notes, and even reading this thread. He created an excel file and helped to to start inputting the numbers I have for food, water, med, pumpkin, weight, basically anything  I have a number for. He helped me see that in the past week her appetite has actually increased a bit. My assignment from him is to weigh her nightly, continue inputting the amount of food she eats (and calories now that I am tracking) and her bowel movements and chart it out in 2 weeks. I'm going continue the prednisolone also (already called the vet & will pick it up tonight). With that information I should be able to tell and show the vet more clearly that the pred is or isn't working.

Going through my notes really helped. It's so easy for me to get overwhelmed. When I noticed she had lost weight is when there was another rainstorm, and I really suspect this is a "thing," because she became constipated right through it and of course that decreased her appetite. Since I've been giving her pumpkin she's been having daily bowel movements.

Thank you for all your suggestions!! I do pet her as much as possible because I noticed a few days ago after a nice session she goes and eats a bit. I've also been keeping the heater on when it's cool outside.

Our ballet production of Sleeping Beauty is on March 25th. It's lovely because 80% adult students, ranging from their 20s to their 70s (yes! 70s!!!). My wonderful teacher works us very hard but in a gentle manner and it's so nice to share a hobby with friends and family. Our teacher made all of our tutu bodices & toppers this year. I'm a fairy in Act 1 & a friend of the princess in Act 2. We don't have many men (only 2 lol) so instead of the princess being courted, she's having a birthday party with friends 

 

Even though I have a killer headache at not even 10AM, at least I feel in control of the situation a bit....

 

[Brian007]

@nevroth  I was told to not give up my day job and booted out of ballet classes when I was just 6 years old  

  This was quite crushing and I don't think the ballet teacher handled it well, I mean, I was only 6 years old! I think it was probably because of a congenital hip displacement in both hips, I used to walk funnily when I was a child.  But the displacement was corrected, and by all accounts, even mine, I am an excellent disco dancer   

  I saw a Matthew Bourne production of Sleeping Beauty at the Festival Theatre in Edinburgh, it was very fancy.  I'm sure your production will be just as good in a different way 

 

[Brian007]

And decrease the pumpkin to 1tsp a day. 

 

 

[artiemom]

 
Thank you @CindyCRNA,

@StephenQ

@Brian007

My vet didn't want to do an ultrasound without the endoscopy because "the results are still inconclusive and they would still recommend an endoscopy."

Meph gets 1/2 tbsp pumpkin mixed with a little water nightly. 

The good news, yesterday Meph weighed 3.65kg. On 2/26/17 she weighed 3.63kg, so not a big difference! She also left good presents for me in the litterbox and ate about 175kcal!! This morning she wasn't in my room at all but running around the living room when I went looking for her

My boyfriend really pulled through for me yesterday. Calming me down, going through all my notes, and even reading this thread. He created an excel file and helped to to start inputting the numbers I have for food, water, med, pumpkin, weight, basically anything  I have a number for. He helped me see that in the past week her appetite has actually increased a bit. My assignment from him is to weigh her nightly, continue inputting the amount of food she eats (and calories now that I am tracking) and her bowel movements and chart it out in 2 weeks. I'm going continue the prednisolone also (already called the vet & will pick it up tonight). With that information I should be able to tell and show the vet more clearly that the pred is or isn't working.

Going through my notes really helped. It's so easy for me to get overwhelmed. When I noticed she had lost weight is when there was another rainstorm, and I really suspect this is a "thing," because she became constipated right through it and of course that decreased her appetite. Since I've been giving her pumpkin she's been having daily bowel movements.

Thank you for all your suggestions!! I do pet her as much as possible because I noticed a few days ago after a nice session she goes and eats a bit. I've also been keeping the heater on when it's cool outside.

Our ballet production of Sleeping Beauty is on March 25th. It's lovely because 80% adult students, ranging from their 20s to their 70s (yes! 70s!!!). My wonderful teacher works us very hard but in a gentle manner and it's so nice to share a hobby with friends and family. Our teacher made all of our tutu bodices & toppers this year. I'm a fairy in Act 1 & a friend of the princess in Act 2. We don't have many men (only 2 lol) so instead of the princess being courted, she's having a birthday party with friends 

 

Even though I have a killer headache at not even 10AM, at least I feel in control of the situation a bit....

You are so fortunate to have such a kind, caring, computer savvy boyfriend! ((hugs)) to him!!

 I need to somehow organize my log. Right now it is a mess. I have calendars, and notes. I am trying to write things down in a notebook, for easier reading. 

Ballet!! wow!! I never took any dance lessons, but as a little girl, I wanted to take ballet!! of course I did!! all little girls did...parents could not afford the dance fees.. Probably just as well. I ended up being a complete klutz! 

Good news about Meph!!!  any small improvements is similar to winning a battle !!!  a small victory!

 

[nevroth]

Ballet is definitely my therapy. I didn't start until I was in my last year of high school and then when my mum passed I found a way to pay for classes myself. Even my boyfriend knows that if I don't go to class for a while (due to illness or the instructor being on vacation), I'll start to get depressed. I switched to flamenco for many years and stopped ballet. I really loved it (and miss it) but I was able to barter for my own classes by teaching children classes in exchange. When I changed careers I switched back to ballet. It's definitely an expense and one my parents couldn't afford when I was growing up either.

Thanks for the pumpkin adjustment @Brian007. Meph likes the pumpkin, always gets a perky look in her eyes when I give it to her. But we can both tell the difference in texture after it's been frozen (partitioned a whole can into 1/2 tbsp cubes). It just doesn't get as smooth, but it'll do. 

Yesterday Meph ate about 156kcal, mostly from Taste of the Wild trout/salmon and a bit of Trader Joes tuna.  Only puddles and no logs (yet) this morning, but again she was out and about. I'm going home for lunch so I can check on her then. 

Flavor fatigue. Haha, I spending more time wondering what she'll have for dinner then my own...

 

[PushPurrCatPaws]

... -

Meph has been on 5mg prednisolone for 3.5wks now for suspected IBD.

...

... He did tell me that usually an endoscopy is done first because the steroids can mask the inflammation, but the sticker shock ($2500) and the chance she could get better without it were the reasons why I chose to go with prednisolone first.

...
She's getting 5mg pred/daily. Though she only has 4 days of it left (including today). I haven't given it yet. I feel like I should try a quick and dirty wean off process then have her go cold turkey. Just need to think about every other day or 2.5mg/daily. Yes I know this means I'll have to put off the endoscopy a little more, but... ... there's always buts. that's my problem; there's always something more I want to do...
...

I am not sure if your vet told you to take your cat off Pred "cold turkey" (which would surprise me, if so!) --- but you should ALWAYS gradually wean off of Pred in a slow, controlled manner. If you just abruptly stop giving it, your cat could experience potentially bad metabolic issues, depending on how long your cat has been taking it and/or if you cat has a tendency towards diabetes (most vets usually won't give Pred to a diabetic cat, but you may be unaware if your cat is or is not prone to high blood glucose at this point in her health). Reducing the Pred dose and then moving to every other day after a day or so, or just moving to every other day even at the current 5mg dose till the medicine is gone, will be better for your cat's health as you take her off the med. I would recommend never going off of Pred "cold turkey" (but, of course, your vet is the most qualified to have the last say-so).

 

[nevroth]

I am not sure if your vet told you to take your cat off Pred "cold turkey" (which would surprise me, if so!) --- but you should ALWAYS gradually wean off of Pred in a slow, controlled manner. If you just abruptly stop giving it, your cat could experience potentially bad metabolic issues, depending on how long your cat has been taking it and/or if you cat has a tendency towards diabetes (most vets usually won't give Pred to a diabetic cat, but you may be unaware if your cat is or is not prone to high blood glucose at this point in her health). Reducing the Pred dose and then moving to every other day after a day or so, or just moving to every other day even at the current 5mg dose till the medicine is gone, will be better for your cat's health as you take her off the med. I would recommend never going off of Pred "cold turkey" (but, of course, your vet is the most qualified to have the last say-so).

It was odd. He said something like, 'I would not continue the prednisolone as it doesn't seem to be working and I don't want to give her necessary medication.' I was also concerned about stopping it 'cold turkey' but I don't think I ever voiced the question. All I can clearly remember after the phone call (oh how I wish I could have somehow recorded it, I record the office visits for future review) was the sense of panic that she only had a few days left and he didn't specifically say he would refill the prescription. When I expressed interest in getting the endoscopy he talked a little more about that and before that a little bit on lymphoma.

Thankfully he put in his notes that it was ok to do so, so I picked it up yesterday. He's away at a conference this week. Supposedly answering emails (though he only answered half the one I sent; he told me that at least 7 days off pred would be necessary before an endoscopy could be taken and to check with a specialist. Well I asked that question because TWO DIFFERENT specialty hospitals told me to ask the current attending vet).

Thank you for your input. I'm still continuing daily pred for now with more thorough documenting for 2 weeks before I reach out to the vet again. Now I'm additionally weighing her (which I know day to day can vary, but I'd rather have the data and not use it) and tracking approx kcal consumed (by weighing the amount of food offered & not eaten).

This vet... Despite the amazing recommendations and reviews my confidence is a bit shaken. I had inquired about Meph being nauseous but he didn't mention it (not even a "can't tell over email, bring her in") and so I have a little voice in my head saying, 'maybe that's it! just a little cerenia- that's the missing link.'

Tracking the calories is helping my anxiety though. The day she ate 175kcal, was because she ate 50g (1.76oz) of Trader Joes tuna and only 27g (<1oz!) Stella & Chewys Duck Duck Goose.

TJ tuna is 100g = 100kcal, so 50g = 50kcal

DDG is 1kg = 4650kcal, or 1g = 4.65kcal, so 27g = 125.55kcal

I hope thats right. So it seemed like a little amount but in reality it was packed with nutrition. She REALLY likes the DDG. I'm afraid of giving it to her again so soon because I don't want her to get sick of it. She nor my other cat will touch the other dry duck food anymore.

No litter box presents at lunch time but the days not over yet...

 

[artiemom]

I agree with @PushPurrCatPaws   about tapering off the dose of steroids. Humans taper off the dose also. It can cause some pretty nasty effects if not slowly weaned off. Perhaps cats are different, but not sure..

Strange that the IM Vet would tell you to ask your Vet about decreasing steroid dose; that is usually done by the specialist. I may have gotten confused about what you are giving. 

IMO, I think that weighing Meph daily is a bit of an overkill. I think it would stress you out even more if you see a very slight weight drop. I think it is better to weigh, at the most, twice a week. That way you can see trends. When Artie is ok, I only weigh once a week. I do twice a week weights if he loses.  Just remember, that poops, and hydration can make a huge difference when you are talking ounces. 

What did the specialist say about pepcid and cerenia? or am I confused again.. sorry, I honestly feel as if I have brain rot...

((Hugs)) to you... enjoy your ballet!! Ballerina!!  

 

[PushPurrCatPaws]

Hi my cat battled severe IBD for 15+ months and Prednisolone helped him a lot.  There were no negative side effects and generally the only side effects in cats (besides feeling better and being better) is a risk down the road for diabetes and a decreased immune system, both acceptable risks when a cat has severe IBD.

To answer your other question, YES a cat can feel nauseous without vomiting, ...

I would just add to your statement (that "generally the only side effects in cats (besides feeling better and being better) is a risk down the road for diabetes and a decreased immune system") by saying that another possibly significant side effect, esp. in IBD cats or cats with other GI issues, would be irritation of the stomach lining and/or development of ulcers -- which can also cause nausea and food avoidance.

I would recommend always trying to give Pred with a meal, so that the stomach isn't trying to "process" the Pred all by itself, with no food to help coat the GI tract and stomach.

 

[nevroth]

 
I agree with @PushPurrCatPaws   about tapering off the dose of steroids. Humans taper off the dose also. It can cause some pretty nasty effects if not slowly weaned off. Perhaps cats are different, but not sure..

Strange that the IM Vet would tell you to ask your Vet about decreasing steroid dose; that is usually done by the specialist. I may have gotten confused about what you are giving. 

IMO, I think that weighing Meph daily is a bit of an overkill. I think it would stress you out even more if you see a very slight weight drop. I think it is better to weigh, at the most, twice a week. That way you can see trends. When Artie is ok, I only weigh once a week. I do twice a week weights if he loses.  Just remember, that poops, and hydration can make a huge difference when you are talking ounces. 

What did the specialist say about pepcid and cerenia? or am I confused again.. sorry, I honestly feel as if I have brain rot...

((Hugs)) to you... enjoy your ballet!! Ballerina!!  

@Artiemom  I hope you don't mind if I use your vet differentiation system!

Well I don't have an IM Vet (yet). Meph's general vet, Dr S, has only prescribed prednisolone. She's taking no other medication currently, just 1 tsp pumpkin. She's been taking 5mg pred/daily for 28 days now, pumpkin for 5 days now. In the middle of the 28 day pred she took a bit of lactulose for a few days but I stopped it when I started the pumpkin (Dr. S was ok with this). Dr. S not commented to me about taking any other medications. During our phone call he mentioned 'if it's lymphoma then there's chemotherapy' but he didn't specify any specific drugs (though I can hazard a guess from others stories).

Dr. S gave me a list of 6 specialists to choose from and the first two I called told me (well the staff member told me) a price range (1200-3500 or 2400-2500 USD!) but both said that Meph's attending vet should be able to tell me how much time off pred is enough. One mentioned she may need blood work to make sure its out of her system. Dr. S emailed me, 

"Ideally, at least for seven days without prednisolone. I would of course ask the specialist to see what they say. "

I haven't asked anyone 'official' about cerenia/pepcid specifically. I asked Dr. S about Meph being nauseous and listed her symptoms (licking her lips a lot and going to the food bowl only to turn away and stare at it) but he did not give a response to that. The email contained a greeting and what I italicized above.

Now I'm scared to ask the vet. I asked my boyfriend to come with me the next time I need to take Meph in, because an objective 3rd person can help remember to ask/bring up things that I'll forget. 

I also think weighing Meph every day is overkill. But my darling boyfriend will scold me if I don't. When I chart things out I will work excel magic to only show weekly or bi-weekly weigh ins.

 

[nevroth]

I would just add to your statement (that "generally the only side effects in cats (besides feeling better and being better) is a risk down the road for diabetes and a decreased immune system") by saying that another possibly significant side effect, esp. in IBD cats or cats with other GI issues, would be irritation of the stomach lining and/or development of ulcers -- which can also cause nausea and food avoidance.

I would recommend always trying to give Pred with a meal, so that the stomach isn't trying to "process" the Pred all by itself, with no food to help coat the GI tract and stomach.

!!!!!!!

I've been giving Meph pred in the mornings but I don't think she eats much during the day. I will switch it up tonight to evenings when she has her main meal.  I have been giving the pumpkin at the same time as pred but I don't think it'll hurt, right?

(Just don't tell my boyfriend!! He might lecture me about confounding variables....)