weaning off prednisolone

[all8now]

Hi, folks-

I'm wondering if anyone has experience weaning a cat off prednisolone. He's been on it for about 14 months now, at 2.5 mg a day, and is showing some side effects. I've bumped him down to 2.5 mg every other day, and I'm wondering if anyone has advice about how long to continue this dose, and what you might have dropped to next?

I am dealing with a vet, but have just ticked her off by announcing I'm weaning him off the pred because I'm seeing things I really don't like- so I'd love to hear someone else's history in addition to her advice.

Thanks!

 

[larsan]

What kind of side effects are you experiencing and why is on it for?

 

[denice]

I've only weaned Patches down twice both times was to find the minimum dose to control symptoms.  He is still on it, has been for 4 years now.  Patches didn't have any issues.  The main thing that happens when weaning off is if it's done too quickly or too much is a return of symptoms.  The symptoms usually will come back with a vengeance, much worse then before starting the steroid.

I know it sounds like you don't trust your vet but weaning off of a steroid is something that should be done with a vet's guidance.

 

[larsan]

We have our little guy on prednisone for allergies. He has been on shots for 5 years. I started a thread on transdermal gel prednisone where I talk about what we're doing now and how it's working, but it is with the advice of our vet. It might be helpful to you

 

[all8now]

Thanks for responding.  I will check out your post, Larsan.

My cat suddenly dropped a pound or so a year and a half ago.  Vet found elevated folate, diagnosed IBD, treated with metronidazole and started oral pred.

Recently I've been seeing muscle wasting, a pot belly, poor coat and general lack of energy and strength.  2 blood tests show lymphocytes dropping and glucose rising beyond the normal range (for the first time ever).  Vet ran a whole pile of tests, x-rays, ultrasound, and even a biopsy- nothing.  So I'm suspecting the pred, giving him iatrogenic Cushing's Disease.

The vet is saying cut back to the same dose every other day for 2 weeks (which I'm absolutely fine with), then maybe take him off completely.  After 14 months, I'm wondering if that's not a bit fast, so I was hoping someone had experience with weaning a cat off pred for some reason, and had thoughts on a slower approach.

Thanks for any suggestions you might have.

 

[all8now]

In case it helps someone else, I'll describe what I'm seeing.  I dropped Gus's steroid dosage to every other day, a week and a half ago.  His energy is way up (playing, walking with me outside, even in the rain), his mood is excellent, appetite very good, weight up a bit with new muscle and fat padding.  My conclusion- kitties are weird, and can have all kinds of side effects.  This is one cat who does NOT do well on steroids, but he seems to be handling the weaning well.  I'll continue very slowly decreasing his dosage.

 

[vmf]

I weaned one of my cats off prednisone few years back. I was just decreasing the dosage and eventually stopped alltogether.

 

[mikeykitteh]

Hello!

I know this thread is over a year old, but was wondering if you could give an update?

I have to wean my cat off of Prednisolone. She is 12 months old and had what the vet suspects was an autoimmune problem with her blood. She was anemic and had almost no platelets. She had 2 transfusions and so far, her blood work is now normal.

She has been on Pred for only 5 days. She is on 3mg twice a day. She is doing so well so we are going to wean her slowly.

I have actually already started weaning her because I literally cannot get her to take the meds consistently.

Were you successful in weaning your cat?

 

[sonic]

It isn't true that if you stop prednisone / prednisolone after being on the medication for an extended period of time that the only problem will be a return of the old symptoms (with a vengeance or otherwise).

Prednisone / Prednisolone are corticosteroids.  Cortisone is produced by your adrenal glands; when a person / cat / dog has been on Prednisone / Prednisolone for too long, your adrenal glands get use to the excess cortisone in the body and the adrenal glands, then make less cortisone, or pending on the dose or length of time on prednisone / prednisolone, the adrenal glands can stop making cortisone altogether.

This is why your veterinarian will recommend "weaning off the medications".  The weaning process is so the adrenal glands will wake up and start producing the cortisone again that the body needs.

If you stop the corticosteroids too quickly, then the adrenal glands will not just take over and make the cortisone that's no longer being added to the system.  This will cause major problems on the body.

As for weaning, pending on the length of time on corticosteroids (prednisolone / prednisone), it can be a slow weaning process.  If the pet has been on these meds for a relatively short period of time and dose (2.5mg - 5mg daily) over (2-3 months), then you could probably get away with reductions every 2wks ie 5mg a day, stepping down to 2.5mg a day for 2wks; then 2.5mg every other day for 2wks; 2.5mg twice weekly for 2wks, then stop.

If it's a larger dose ie 10mg or a longer period (six months or more), then you should step down every 2 months ie 10mg a day, 5mg a day for 2 months, 5mg every other day for 2 months, 2.5mg a day for two months and then 2.5mg every other day for 2 months and then twice weekly @ 2.5mg for 2 months and then twice weekly for 2 months.

This especially goes for people who have had pets on corticosteroids for years.

 

[darkhorse321]

I too am seeing muscle wastage on my boy and want to wean him off pred---vet said you have to wean them off because if you just stop all together, the body may not be able to create enough in the body to compensate since it's been getting it via medication.

Bandit is getting the pot belly and muscle weakness, but he's still tough. I'm going to the vet to pick up the pred tomorrow and want to drop Bandit to 1 and a half.

Good luck with your kitty!

 

[jtomalin]

I see this post being a year old... We have had a kitty (about 11 months) who became unable to walk at 4 months. Head tremors, odd gait, and overall wouldn't grow. The steroid has been a miracle in bringing her back to walking, playing, and being her normal self. We've tried weening her off, but the systems seem to come back within 3 days.

 

[cat princesses]

Have you considered Atopica? I am using that for my cat with severe allergies - it's significantly safer than using steroids. I'd look into that if you can - I also posted about a rebate being available which makes it very affordable.

 

[brookecm1]

I'm really struggling with what is the best thing to do for my cat Bella. She developed Asthma about 4 months ago and the vet has had her on pred now for about 4 months. When the asthma appeared, it was just horrible. The attacks were so incredibly scary. And she wasn't recovering between them, I thought for sure I was going to lose her. Since being on the pred, she hasn't had a single asthma attack. I also made some enviromental changes too - I have air purifiers in every room now, I upgraded my HVAC filters to high quality allergen ones, and I never open my windows. And now her asthma is completely under control. HOWEVER It breaks my heart though, because the meds have taken any life out of her. It may be keeping her alive, but all she does is sleep, stare out into space, eat, drink, and go the bathroom. The lack of energy is so disheartening. I cry sometimes and apologize to her, because I'm the one giving her the med and doing this to her. I've been tapering her off the pred from 10mgs to 5 mgs over the last 2 months and today am now back down to 2.5mgs. I've tried tapering a few times, but every-time we get down to 2.5 mgs daily, she gets so restless, irritable, and starts smaking her lips obsessively. Sometimes she will just meow quietly at the wall. If I give her the 2nd pill to make it 5mgs, these symptoms all goes away. Could it be whenever we get down to 2.5 mgs - her body needs time to adjust to the 2.5mgs? I get so anxious when when the obsessive lick smacking starts and she becomes an angry irritable cat, that I end up just giving her that 2nd pill. But it's moving backwards because i want her off this med altogether if I can. I want my little kitty to enjoy life again. To chase a ball. Or look out a window. And more than anything, to reconnect with her best friend - my other cat Miracle. For 7 years they have been inseparable, and these past few months, she wants nothing to do with him. I can tell he's depressed without her too. I am just praying that when this drug is out of her system, that her personality and energy starts to resurface. There's an inhaler alternative with less side effects, but it's almost $350 a month and it breaks my heart, I just don't make enough money each month to pay that. If I had it, I would buy it in a heart beat for her. I just need to figure out if I should push through these 2.5 mgs symptoms that appear as long as she doesn't have an asthma attack or keep her on this drug like the vet suggests. Just in my heart, I feel like this drug has taken her life away. She may still be here physically, but she's missing on the inside I am praying we can get this dose down and her sweet and cuddly self starts to come back to us. I talk to my vet on a regular basis and he points out she's not in pain, she's eating, she's drinking, she's going to the bathroom, she's not having asthma attacks. But I don't know, it's hard to look at her just staring off into space instead of making silly noises at birds in the window

 

[ssjewell]

I was reading your heartbreaking post about your cat with asthma and wanted to let you know that you can purchase the Flovent for your Aerokat inhaler from Canada for much, MUCH less than it sells for in the U.S. I have used the Aerokat inhaler with Flovent (fluticasone propionate) (I believe it is sold in Canada under Flixotide Evohaler (known as Flovent HFA 110mcg in the U.S.) for my cat Max until he died recently and wasn't paying that much for the solution when I ordered it from CanadaDrugs.com. I have also purchased it from PlanetDrugsDirect.com for much less. Flixotide Inhaler 125mcg.

 

[marilynr]

I'm really struggling with what is the best thing to do for my cat Bella. She developed Asthma about 4 months ago and the vet has had her on pred now for about 4 months. When the asthma appeared, it was just horrible. The attacks were so incredibly scary. And she wasn't recovering between them, I thought for sure I was going to lose her. Since being on the pred, she hasn't had a single asthma attack. I also made some enviromental changes too - I have air purifiers in every room now, I upgraded my HVAC filters to high quality allergen ones, and I never open my windows. And now her asthma is completely under control. HOWEVER It breaks my heart though, because the meds have taken any life out of her. It may be keeping her alive, but all she does is sleep, stare out into space, eat, drink, and go the bathroom. The lack of energy is so disheartening. I cry sometimes and apologize to her, because I'm the one giving her the med and doing this to her. I've been tapering her off the pred from 10mgs to 5 mgs over the last 2 months and today am now back down to 2.5mgs. I've tried tapering a few times, but every-time we get down to 2.5 mgs daily, she gets so restless, irritable, and starts smaking her lips obsessively. Sometimes she will just meow quietly at the wall. If I give her the 2nd pill to make it 5mgs, these symptoms all goes away. Could it be whenever we get down to 2.5 mgs - her body needs time to adjust to the 2.5mgs? I get so anxious when when the obsessive lick smacking starts and she becomes an angry irritable cat, that I end up just giving her that 2nd pill. But it's moving backwards because i want her off this med altogether if I can. I want my little kitty to enjoy life again. To chase a ball. Or look out a window. And more than anything, to reconnect with her best friend - my other cat Miracle. For 7 years they have been inseparable, and these past few months, she wants nothing to do with him. I can tell he's depressed without her too. I am just praying that when this drug is out of her system, that her personality and energy starts to resurface. There's an inhaler alternative with less side effects, but it's almost $350 a month and it breaks my heart, I just don't make enough money each month to pay that. If I had it, I would buy it in a heart beat for her. I just need to figure out if I should push through these 2.5 mgs symptoms that appear as long as she doesn't have an asthma attack or keep her on this drug like the vet suggests. Just in my heart, I feel like this drug has taken her life away. She may still be here physically, but she's missing on the inside I am praying we can get this dose down and her sweet and cuddly self starts to come back to us. I talk to my vet on a regular basis and he points out she's not in pain, she's eating, she's drinking, she's going to the bathroom, she's not having asthma attacks. But I don't know, it's hard to look at her just staring off into space instead of making silly noises at birds in the window

I'm really struggling with what is the best thing to do for my cat Bella. She developed Asthma about 4 months ago and the vet has had her on pred now for about 4 months. When the asthma appeared, it was just horrible. The attacks were so incredibly scary. And she wasn't recovering between them, I thought for sure I was going to lose her. Since being on the pred, she hasn't had a single asthma attack. I also made some enviromental changes too - I have air purifiers in every room now, I upgraded my HVAC filters to high quality allergen ones, and I never open my windows. And now her asthma is completely under control. HOWEVER It breaks my heart though, because the meds have taken any life out of her. It may be keeping her alive, but all she does is sleep, stare out into space, eat, drink, and go the bathroom. The lack of energy is so disheartening. I cry sometimes and apologize to her, because I'm the one giving her the med and doing this to her. I've been tapering her off the pred from 10mgs to 5 mgs over the last 2 months and today am now back down to 2.5mgs. I've tried tapering a few times, but every-time we get down to 2.5 mgs daily, she gets so restless, irritable, and starts smaking her lips obsessively. Sometimes she will just meow quietly at the wall. If I give her the 2nd pill to make it 5mgs, these symptoms all goes away. Could it be whenever we get down to 2.5 mgs - her body needs time to adjust to the 2.5mgs? I get so anxious when when the obsessive lick smacking starts and she becomes an angry irritable cat, that I end up just giving her that 2nd pill. But it's moving backwards because i want her off this med altogether if I can. I want my little kitty to enjoy life again. To chase a ball. Or look out a window. And more than anything, to reconnect with her best friend - my other cat Miracle. For 7 years they have been inseparable, and these past few months, she wants nothing to do with him. I can tell he's depressed without her too. I am just praying that when this drug is out of her system, that her personality and energy starts to resurface. There's an inhaler alternative with less side effects, but it's almost $350 a month and it breaks my heart, I just don't make enough money each month to pay that. If I had it, I would buy it in a heart beat for her. I just need to figure out if I should push through these 2.5 mgs symptoms that appear as long as she doesn't have an asthma attack or keep her on this drug like the vet suggests. Just in my heart, I feel like this drug has taken her life away. She may still be here physically, but she's missing on the inside I am praying we can get this dose down and her sweet and cuddly self starts to come back to us. I talk to my vet on a regular basis and he points out she's not in pain, she's eating, she's drinking, she's going to the bathroom, she's not having asthma attacks. But I don't know, it's hard to look at her just staring off into space instead of making silly noises at birds in the window

My cat has had asthma most of his life. He is now almost 15. Long ago the vet recommended Flovent (Flixotide in foreign countries). This is also used by humans. I purchased it here in the U.S. a few times, but you are right, it is ridiculously expensive. I researched sites online and came upon PharmacyChecker.com. You can compare prices and should do so each time you have to order it. You will need a prescription from your vet. You will also have to purchase an inhaler which you can get from Aerokat. I give 2 puffs to my cat every morning and every night. Recently, I have had to start giving it to him during the afternoon as well. I have seen no side effects other than maybe increased thirst. It isn't cheap, but it is more affordable - especially if you order a supply for at least 3 months. The pharmacy I use continues to honor the original price I bought it at. The price changes all the time. If you would like some assistance in how best to use the inhaler or anything else regarding this method, I would be happy to email with you or speak on the phone.

 

[altamont03]

I would only add to not be intimidated by training your cat to use an AeroKat inhaler. Best video is on YouTube showing the cat getting accustomed to the inhaler and how to train them.
My cat was diagnosed with allergic adthma about 6 months ago and went on 0.050 ml of prednisolone transdermal once a day. We soon had to increase it to 2x day. A few weeks ago her ear tips started to droop. This is quite noticeable in an Egyptian Mau. She was having lots of asthma attacks. I had been giving her treats out of the AeroKat mask for several months. It has taken only a week to get her to having Flovent a.m. and p.m. and she is doing beautifully. One tip: buy the 220cmg strength and you use fewer puffs. I read this thread to get advice on weaning her off the transdermal. Good luck with your kitty, BrookeCm1. My heart goes out to you.

 

[altamont03]

I am weaning my cat off transdermal prednisolone(o.o5 mg/ml twice daily for 6 months);last 10 days we have been transitioning onto Flovent, 1-2 puffs 220mcg twice daily. My vet’s weaning instructions for this scenario were:” pred twice daily for 5 more days then go to ONCE daily for 7 days and then every other day for 4 more doses. If she is still doing will with the inhaler you can stop the pred.“

So for a cat on a relatively low dose of prenisolone (research shows that transdermal med absorption could be as low as 10%) the weaning period is, nonetheless, is almost 3 weeks.
My vet also noted that the doses were low so that overlapping them would not be an issue in Miyu’s case.

Every cat and med situation is different so get your vet’s specific advice on the weaning periond and step-down dosages. Your vet knows how long your cat’s adrenals need to start producing sufficient cortisol again.

 

[altamont03]

I am weaning my cat off transdermal prednisolone(o.o5 mg/ml twice daily for 6 months);last 10 days we have been transitioning onto Flovent, 1-2 puffs 220mcg twice daily. My vet’s weaning instructions for this scenario were:” pred twice daily for 5 more days then go to ONCE daily for 7 days and then every other day for 4 more doses. If she is still doing well with the inhaler you can stop the pred.“

So for a cat on a relatively low dose of prenisolone (research shows that transdermal med absorption could be as low as 10%) the weaning period is, nonetheless, is almost 3 weeks.
My vet also noted that the doses were low so that overlapping them would not be an issue in Miyu’s case.

Every cat and med situation is different so get your vet’s specific advice on the weaning periond and step-down dosages. Your vet knows how long your cat’s adrenals need to start producing sufficient cortisol again.

 

[altamont03]

Just an update to training your cat to use the AeroKat inhaler for asthma. My other Mau, Toshi, was more resistant to learning to use an inhaler. I had several false starts and gave up. But, transdermal prednisolone was beginning to cause him metabolic symptoms. After a period of paying more attention to him and building trust, I started to gradually accustom him to the mask, and finally, the spacer and inhaler. He was still getting transdermal until he got the hang of the inhaler. Within a week or two he was doing 5 breaths per puff and now he is up to 8-10 twice a day. His congestion is improving and he has more energy. I hope to try him on one dose a day after about two weeks.