Risks of Long Term Steroid Use for Allergies?

hillyy13

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Hi all,

I haven't posted on here for quite some time- my last post over a year ago was when we first discovered Cecil's skin issues and we had no idea what was going on! Since then we have had lots of tests and treatments done and the vet has diagnosed that Cecil has a number of food allergies that are causing his skin to become very dry, itchy and sore. Unfortunately, the blood tests showed that he was allergic to all foods on the list so finding a treatment option is very difficult, we are in the process of trying exclusion diets to find out what he is least allergic to.

Because of this, Cecil has been on low dosage steroids for a while now as it's the only way the itching can be kept at bay... he is really miserable without them. He is currently on 1/2 a tablet (1mg) every other day. I guess I just wanted to find out if anyone had any experiences of cats being on long term steroids or any knowledge on the risks of this? I have read that it's not good for a cat to be on them long term but I'm struggling to find evidence of exactly how bad they are/how much they may shorten life expectancy etc. We will keep pushing with other treatment options but if all else fails we need to decide if he is better off on long term steroids and a better quality of life or to come off of them and live his life with the cone of shame.

Any advice would be much appreciated. Thank you :)
 

LTS3

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Steroid use can cause diabetic-like symptoms: excessive hunger and thirst and urination. Blood glucose levels are slightly elevated. Stopping the steroid use will make the symptoms go away. Long term use of steroids (ie daily for months) can induce diabetes which can be managed with insulin and diet.

There are threads in the Nutrition forum here on TCS about foods to feed for cats with various food sensitivities. You can start a thread there to get more help.

Any food trial needs to be done for at least 13 weeks if not longer to see if it helps the symptoms or not. It's a long process that can be frustrating at times. Novel proteins like rabbit and venison are often helpful. Some people find a raw or home cooked diet is what works best for their cat's food sensitivities.
 

dahlia

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Hello,
One of my cats has been on steroids in one form or another for his asthma for about 5 years now. He is around 9 years old now. He started out with shots of steroids because of coughing episodes but when I figured out it was going to be a forever thing, I went to oral. He does .15 ml every other day. For awhile it was every three days but he would start to cough so this seems to work the best. I put it in his food. He is doing great. I don't free feed so weight gain isn't necessarily an issue although he is a little heavier than I would like because sometimes he gets into the other cats' food at feeding time before I can stop him. The last time I brought him in for bloodwork, they were a little worried that he might have high cholesterol (possible indication of diabetes) so next time I need to fast him prior to the bloodwork. I don't think he has anything wrong though because everything else is normal. He has normal energy levels, his fur is great and he isn't drinking an excessive amount of water.
I know steroids aren't great but it hasn't been a problem so far. It does not seem to impact his personality at all. If he lives until 13 or so, he will have lived as long as my previous cats, which would not be the case if his asthma was not controlled so I figure the trade off is worth it.
 

daftcat75

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As far as my reading reported, when researching long-term steroid use in my angel Krista with her stubborn lymphoma, the risk of long-term damage is greatly reduced with every other day dosing vs every day (like my poor Krista and I believe that played a part in her demise. 😿) Still. This is a conversation you should be having with your vet. Good luck on the food trials!
 

WMM201

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I'm so sorry your cat has allergies. My cat also has allergies (like human hay fever, really terrible in spring through fall). Her vet ruled out steroids for her because she is an early CKD cat, and the vet didn't want to risk any kidney damage from long term use. My cat is on hydroxyzine as her antihistamine, after we switched from chlorpheniramine because it wasn't effective enough. It seems to be working okay for my cat, but her allergies may be very different from your cat. If only my vet would allow steroids for my cat, it would help with her arthritis also. However, a lot of people's cats do fine with the steroids, I believe.
 
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hillyy13

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Steroid use can cause diabetic-like symptoms: excessive hunger and thirst and urination. Blood glucose levels are slightly elevated. Stopping the steroid use will make the symptoms go away. Long term use of steroids (ie daily for months) can induce diabetes which can be managed with insulin and diet.

There are threads in the Nutrition forum here on TCS about foods to feed for cats with various food sensitivities. You can start a thread there to get more help.

Any food trial needs to be done for at least 13 weeks if not longer to see if it helps the symptoms or not. It's a long process that can be frustrating at times. Novel proteins like rabbit and venison are often helpful. Some people find a raw or home cooked diet is what works best for their cat's food sensitivities.
Thank you this is really helpful! It’s interesting to know that steroid induced issues can usually be managed.

I am definitely considering trying a protein such as rabbit as this is something we haven’t explored before. I will take a look at the nutrition forum to try and get some more info before buying anything. Thanks again!
 
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hillyy13

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Hello,
One of my cats has been on steroids in one form or another for his asthma for about 5 years now. He is around 9 years old now. He started out with shots of steroids because of coughing episodes but when I figured out it was going to be a forever thing, I went to oral. He does .15 ml every other day. For awhile it was every three days but he would start to cough so this seems to work the best. I put it in his food. He is doing great. I don't free feed so weight gain isn't necessarily an issue although he is a little heavier than I would like because sometimes he gets into the other cats' food at feeding time before I can stop him. The last time I brought him in for bloodwork, they were a little worried that he might have high cholesterol (possible indication of diabetes) so next time I need to fast him prior to the bloodwork. I don't think he has anything wrong though because everything else is normal. He has normal energy levels, his fur is great and he isn't drinking an excessive amount of water.
I know steroids aren't great but it hasn't been a problem so far. It does not seem to impact his personality at all. If he lives until 13 or so, he will have lived as long as my previous cats, which would not be the case if his asthma was not controlled so I figure the trade off is worth it.
oh wow 5 years! That’s really good to hear that he’s doing well and that the steroids haven’t caused any major damage - I was under the impression that if Cecil had steroids now he wouldn’t even be here in five years!

Cecil is similar with the dosage, we’ve tried 1/2 a tablet every 3 days but he started to get more irritated again. It’s crazy how one extra day can make such a difference!

We will definitely try to explore other options and carry on with food trials but I completely agree that the trade off is worth it for a cat that has had a happy healthy life. Thank you for the advice :)
 
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hillyy13

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As far as my reading reported, when researching long-term steroid use in my angel Krista with her stubborn lymphoma, the risk of long-term damage is greatly reduced with every other day dosing vs every day (like my poor Krista and I believe that played a part in her demise. 😿) Still. This is a conversation you should be having with your vet. Good luck on the food trials!
Ah that’s good to hear, as Cecil seems to be ok on 1/2 tablet every other day. I am sorry to hear about your angel. How long was she on steroids for?

we will definitely keep having conversations with the vet and keep going with the food trials, however long it takes!
 
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hillyy13

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I'm so sorry your cat has allergies. My cat also has allergies (like human hay fever, really terrible in spring through fall). Her vet ruled out steroids for her because she is an early CKD cat, and the vet didn't want to risk any kidney damage from long term use. My cat is on hydroxyzine as her antihistamine, after we switched from chlorpheniramine because it wasn't effective enough. It seems to be working okay for my cat, but her allergies may be very different from your cat. If only my vet would allow steroids for my cat, it would help with her arthritis also. However, a lot of people's cats do fine with the steroids, I believe.
Oh I’m sorry to hear about your cats allergies too... it can be so stressful can’t it. What is CKD if you don’t mind me asking?

That is really interesting about the antihistamines, as Cecil has been taking cetirizine for a few months now and they haven’t seemed to do much so it might be worth us asking for a different type. I will make note of that one and see what they say.

Have you ever considered immunotherapy? This was something else we were reading up about, but I don’t know if it’s effective for food allergies.
 

daftcat75

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Ah that’s good to hear, as Cecil seems to be ok on 1/2 tablet every other day. I am sorry to hear about your angel. How long was she on steroids for?

we will definitely keep having conversations with the vet and keep going with the food trials, however long it takes!
Krista was on prednisilone daily for the last 7 months of her life. First, 5 mg per night. And when the addition of leukeran (chemotherapy) didn't produce a complete remission, my vet's answer was to throw more pred at it. Her dose went up to 7.5 mg/night and she was on that for several months. Through mistakes of my own and lack of expertise from my vet, things would get worse before they got better. A middle ear infection forced a change in the way I was giving her pred: from pill halves wrapped in fish flakes, a trigger food 🤦‍♂️, to transdermal gel, and a dose reduction to 5 mg/night since 7.5 wasn't having any additional benefit. That (removing the fish flakes) finally brought her remission. But it was too little too late. A bladder infection the following month would prove too much for her tiny, lymphoma and steroids-weakened body and immune system. 😿

If there are two lessons I could get across to you about our experience, it would be these:

1. Do whatever it takes to identify triggers and eliminate them! Completely! I don't care how much he might like a fish treat. If fish is a trigger, don't give it, and don't look back.

2. Consult with a specialist. General vets are often spread too thin and their experience is likewise a jack-of-all-trades and master of none. Seek the masters who can spend the kind of time on your case that it requires.
 

LTS3

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What is CKD if you don’t mind me asking?

Chronic kidney disease.

One of my cats occasionally takes pred for his IBD and asthma. He just started a new course last week and the vet just reduced the dose by half. The IBD symptoms are gone but now I have to deal with the constant whining for food and bigger clumps of pee in the litter box :rolleyes: Those diabetic-like symptoms will mostly be gone when the dose gets reduced again in 2 weeks.
 

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I was also going to ask if you’ve tried antihistamines. There are a bunch that cats can take. The effects seem to be pretty variable, some cats respond well to some antihistamines and others they don’t work at all but it’s worth a try.
If the vet has titrated the steroids down to the lowest dose that treats the skin problems it should be ok - definitely get regular blood work but the possible side effects of the steroids are better than a sad itchy cat that could easily get a skin infection!
 

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Yes, Mumu has chronic kidney disease. Because her disease is early, and she is not that old, the vet didn't want to risk damaging her kidneys with long term steroid use. The antihistamines have worked okay for Mumu. She still gets some coughs sometimes, but way, way less often than before. Plus she would get bad ear infections that wouldn't go away during hay fever season, and I think the antihistamines have helped. There are several kinds that are used for cats, so definitely ask your vet to switch if the cetirizine hasn't been as effective. Like K kittenmittens84 said, it kind of depends on the cat! Good luck!
 

MimitheCat

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Hello,
One of my cats has been on steroids in one form or another for his asthma for about 5 years now. He is around 9 years old now. He started out with shots of steroids because of coughing episodes but when I figured out it was going to be a forever thing, I went to oral. He does .15 ml every other day. For awhile it was every three days but he would start to cough so this seems to work the best. I put it in his food. He is doing great. I don't free feed so weight gain isn't necessarily an issue although he is a little heavier than I would like because sometimes he gets into the other cats' food at feeding time before I can stop him. The last time I brought him in for bloodwork, they were a little worried that he might have high cholesterol (possible indication of diabetes) so next time I need to fast him prior to the bloodwork. I don't think he has anything wrong though because everything else is normal. He has normal energy levels, his fur is great and he isn't drinking an excessive amount of water.
I know steroids aren't great but it hasn't been a problem so far. It does not seem to impact his personality at all. If he lives until 13 or so, he will have lived as long as my previous cats, which would not be the case if his asthma was not controlled so I figure the trade off is worth it.
May I ask what type of steroids your cat is taking and how you administer in food? Our vet has prescribed prednisolone for our cat and we are trying different ways to get her to take it (fights hard against pills, currently we have a liquid). Thank you!
 

kittenpetals

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The main risks I know of are diabetes and kidney disease. There is also more chance of developing infections, which steroids can mask the symptoms of.

My girl has been on daily prednisolone for 10 months for an immune-mediated disease. We get a biochemistry blood work panel every 6 months to make sure there's no damage from the pred.
 

kittenpetals

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May I ask what type of steroids your cat is taking and how you administer in food? Our vet has prescribed prednisolone for our cat and we are trying different ways to get her to take it (fights hard against pills, currently we have a liquid). Thank you!
I give my cat liquid prednisolone and this has always worked for us. I put a tiny portion of wet food into her bowl and then add the pred. If I notice any pred left, I spoon out some gravy from the wet food and add it into the bowl so she licks the rest. Once I'm sure she's finished it all, I proceed to give her the rest of the wet food. I hope this helps!
 

dahlia

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May I ask what type of steroids your cat is taking and how you administer in food? Our vet has prescribed prednisolone for our cat and we are trying different ways to get her to take it (fights hard against pills, currently we have a liquid). Thank you!
My cat is on liquid prednisolone as well and, like Kittenpetals, I put down a tiny portion of wet food, put the steroids on and then put some more wet food over the top. If he seems reluctant, I put a few small pieces of salmon freeze tried treats on top and that always does the trick.
 

daftcat75

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If the liquid is hard to give, I’ve had pred compounded as a transdermal gel. I used to give Krista pred as a “wet willy” in her ear. She wasn’t terribly thrilled about that. But she came to learn that the wet willy meant dinner followed. It was easier than the pill and she had a reaction to the liquid. Possibly a compounding ingredient or possibly the flavoring I chose for her.
Prednisolone Twist-a-Dose Transdermal Gel
 
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