Prednisolone dosage - is 10mg a day super high? Worried about side effects

[Robin1959]

My cat had vomiting about a month ago for one day, and after a round of antibiotics an ultrasound was recommended, even though all symptoms had subsided. The ultrasound showed intestinal thickening and they say its "suspected lymphoma OR IBD." Vet has recommended 10mg a day for three weeks, then titrate down, and I'm worried that is too high. Advice? Go with it? Only do 5mg? Also ordered Vitality Science kit for immune system, switched to Savage Cat raw diet, and giving Omega-3s. Any advice on this steroid protocol would be so welcomed. Current state of kitty is: eating, happy, litterbox all fine, firm poop.
Thank you, Robin

 

[daftcat75]

You don't say how much your cat weighs. A 10 mg dose may be a lot for my late IBD kitty Krista who was only 7 lbs (and falling) when she started on pred. But if you have a 20 lbs Maine Coon, that may be an appropriate dose. I know the vet wants to eliminate that thickening and that's the thinking behind blasting him/her with a high dose.

If kitty is doing great without symptoms, you could certainly give all the other stuff a chance to do its thing (Vitality Science, raw diet, omega-3's), and see how kitty does with that. Any constipation? That's sometimes a sneaky symptom that flies under the radar when most people expect vomiting and diarrhea for IBD/lymphoma.

If it were my kitty, I wouldn't be so eager to rush into steroids or IBD/lymphoma treatment if you're not seeing any symptoms. But if you are going to skip the steroids right now, I would definitely plan on a follow-up ultrasound in three to six months to see if things are getting better or worse.

 

[Robin1959]

You don't say how much your cat weighs. A 10 mg dose may be a lot for my late IBD kitty Krista who was only 7 lbs (and falling) when she started on pred. But if you have a 20 lbs Maine Coon, that may be an appropriate dose. I know the vet wants to eliminate that thickening and that's the thinking behind blasting him/her with a high dose.

If kitty is doing great without symptoms, you could certainly give all the other stuff a chance to do its thing (Vitality Science, raw diet, omega-3's), and see how kitty does with that. Any constipation? That's sometimes a sneaky symptom that flies under the radar when most people expect vomiting and diarrhea for IBD/lymphoma.

If it were my kitty, I wouldn't be so eager to rush into steroids or IBD/lymphoma treatment if you're not seeing any symptoms. But if you are going to skip the steroids right now, I would definitely plan on a follow-up ultrasound in three to six months to see if things are getting better or worse.

THANK YOU SO MUCH FOR REPLYING daftcat75
She does NOT have constipation. I keep the equivalent of clinical notes, and now with her new diet we poop daily and it is firm, but not hard. Gwyneth weighs 12 pounds. I was almost ready to try the 10mg, but you're helping me lean back to the 5mg a day for 3 weeks. And then I want to titrate OFF. The vet is saying after the 3 weeks, then 7.5 a day (not telling her I'm not doing the 10, so that would be 2.5) but for how long? They haven't said, other than "once clinical signs go away" but they HAVE gone away. So, my plan is to finish this 3 weeks, or 10 days maybe?, and then follow a titration schedule, stick to my holistic plan and re-do the ultrasound, as you mention. I appreciate your feedback greatly.

 

[daftcat75]

Do NOT off-road it with steroids. Either follow the vet's prescription or don't do it at all. Steroids is not a medication you can start and stop. It requires a ramp-down. You'll want to do all steps of steroids with the vet's guidance. If you're not comfortable with 10 mg, call the vet back and ask if you can do five instead. But make sure your vet is onboard. You can do damage to her if you don't ramp off appropriately. I also don't know if a half measure (5 mg) is worth the effort. This is something you should also discuss with your vet. She may say the same: "either do 10 or don't do it." It's okay to disagree with your vet and it's okay to tell them so. But, especially with steroids, it's NOT okay to write your own prescriptions. If it were my kitty, I would do food and supplements and skip steroids altogether since she doesn't have clinical signs (other than the ultrasound) to evaluate her progress. You can certainly introduce more trouble than she's currently having.

 

[Robin1959]

Thanks again daftcat75 I hear you loud and clear - I was indeed "off-roading" on my last response. I have no intention of stopping the 5mg abruptly (only been on 3 days), but I guess the alternative plan would be to go up to the vet's recommended 10mg (fed 12 hours apart in a 24 hour period, which vet said was ok). And then, once finished, I can tell the Vet I have made the decision to come off them, and get her advice on how. Again, appreciate your feedback.

 

[daftcat75]

My concern with doing both steroids and the food plus supplements is if it works or if it doesn't work, who takes the credit or the blame? You should really do changes incrementally rather than everything at once. But since you've already started the steroids, I would call the vet back and discuss whether to proceed at 5, go up to 10, or hold off altogether. At three days, you may not need a ramp off period. But only the vet can answer that.

 

[Robin1959]

daftcat75 That makes a lot of sense. Especially because after the first incident of vomiting March 7, there have been no clinical signs. So I asked my vet, why are we treating the ultrasound instead of the cat (given that all symptoms abated) and she said she didn't want things to get worse (meaning worse than what the ultrasound showed, which was thickening in one place only - tho a place that is sometimes indicative of lymphoma, though not always!). That's the frustrating part. Agreed, I won't know which is working.
I'm curious about your journey, but perhaps there is somewhere I can read yours. I am sorry for the loss of your kitty, Krista.

 

[daftcat75]

My journey was a 200 page marathon thread titled Krista's Care. I did off-road quite a bit with her treatment which is why I discourage it so vehemently today. It left me out on many limbs with no support below me and no-one to bring me back to solid ground. It was a very lonely and frustrating place. I didn't agree with my vets often and I didn't think they were helping other than running tests and writing prescriptions. I can never know the answer to this. But I abruptly changed her steroid dose in her last week. The vets assure me that she had too much other stuff going on that the change in dose wouldn't have precipitated the rapid decline. But then what good would it serve anyone if they could and did confirm the steroids dose change was partly to blame? The sad truth is that she just ran out of cat. She had lost too much weight and her immune system was decimated from being on steroids and chemo for many months. A bladder infection proved too much for her.

I'm not really sure where to jump into this thread to pick up her final IBD/lymphoma battles. But maybe start with a good memory of driving back from the very last dental appointment she would ever need (removal of her remaining teeth to prevent end her resorptive lesions struggles.) I made the mistake of feeding her a favorite food to help get her eating back up after surgery. Her favorite food was an IBD trigger. No one can say for sure. But I feel like I may have precipitated her decline from a well-managed IBD into lymphoma. Cancer is attracted to chronic inflammation.

Krista's Care

For your case, I would simply stick with food and supplements and re-test the ultrasound in three to six months. If you do get clinical signs before then, re-visit the steroids proposition. If the inflammation did not abate with food and supplements alone, you can also re-visit the steroids. But if the food and supplements alone can solve the inflammation, then save the steroids for when they can't. That's my unprofessional opinion on the matter. If you're concerned that it may be lymphoma or that it could turn into lymphoma, monitor her weight on a weekly basis. Pick up a baby scale and weigh her no more than once a week, preferably same time and place each week. As long as she is maintaining or even gaining weight, it is most likely not cancer. The sad truth is that if it is cancer, you won't miss it. It's just how long does she lose weight before you notice? That's a hallmark sign: rapid and unrelenting weight loss despite an adequate or more than adequate intake of nutrition.

 

[Robin1959]

Thank you for sharing. I can feel the emotion in your writing. Thank you for the link also. I'll get the baby scale - was using my own scale, holding her, getting off, figuring the difference. Not so scientific. Your words and advice are very wise, gained through lots of experience I see, and boy do I understand the wondering. I've had two other cats where I second guessed the vet somewhat - neither ended well, as I somewhat froze and was unable to act. This time I'm able to keep it together enough to make some sensible decisions. I also joined the "Raw feeding cats with IBD" on facebook to see what's happening there. It's hard to find an exact match 'other cat' to sort of compare your journey to. They all seem somewhat different. But I'm staying vigilant and feeling hopeful I can give Gwynnie a good quality of life. All fingers and toes crossed.