? Pancreatitis best steroid has anyone used budesonide?

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Tuxedo Mom

Tuxedo Mom

Member Since 2014
Tuxie has chronic pancreatitis, but has only had two brief episodes in the last year where he was sick and required treatment. I had the spec fPLI redone and he is coming back very high (50 with reference range <3.5) . The vet wants to try steroids to try to improve the inflammation. At this point his diabetes is not regulated, so this concerns me.

Can Budesonide be used to treat pancreatitis rather than prednisolone?

Thanks for any input.
 
Toby has been on 5 mg of Prednisolone 2.5mg in morning and 2.5mg at night for 2 years now for inflammation of the pancreas. It has kept in under control no more episodes. Every time we have tried to take him off or cut him down he gets sick. The vet and I agree that it is better to keep him on it than to try and keep taking him off. He is also a high dose kitty 15 units a day down from 18 units. Have not tried budesonide. Heard that it is better than Prednisolone. Just had Toby's blood work done and it all came back normal.
 
Peg and Toby said:
Toby has been on 5 mg of Prednisolone 2.5mg in morning and 2.5mg at night for 2 years now for inflammation of the pancreas. It has kept in under control no more episodes. Every time we have tried to take him off or cut him down he gets sick. The vet and I agree that it is better to keep him on it than to try and keep taking him off. He is also a high dose kitty 15 units a day down from 18 units. Have not tried budesonide. Heard that it is better than Prednisolone. Just had Toby's blood work done and it all came back normal.
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Thank you for your reply. Tuxie has only had 2 minor episodes in the last year, which responded quickly with Sub Q fluids and a cerenia shot. However since his fPLI is so high the vet is advising steroids to get the inflammation down. He also had an U/S done months ago which showed an inflammed pancreas. Since Tuxie is not well regulated I was wondering if the budesonide would work with pancreatitis since it apparently has less effects on the glucose levels than prednisolone. I am still waiting for all the blood work to come back and then the vet wants to meet and discuss a treatment plan.
 
I think Budesonide only works in the gut. It was initially created for treating Crohn's disease in humans, then it went over to the vet world too. I don't think it would target the pancreas but obviously check with the vet. My guess is you may need to use prednisolone and increase the insulin if needed.
 
Cat Ma said:
Here's a handy primer on Pancreatitis: http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

Budesonide is usually prescribed for IBD. But the article Larry and Kitties pointed out does mention use of Budesonide in some cases involving both IBD and pancreatitis.
Worth asking your vet if this would work for your cat or not.
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Thanks for the reply. My Tuxie is not symptomatic at all for pancreatitis, but with the U/S and high spec fPLI he definitly has pancreatic inflammation. I really don't understand with the fPLI being so high, that he does not have more episodes. As I said only twice in the last year did he had inappetance and vomitting and that resolved within a day with Sub Q and one shot of cerenia. Other than that he has an overly good appetite and has never lost any weight since he was diagnosed with FD almost 10 months ago...in fact he put on 2 lbs after starting insulin, and is almost on the overweight side in spite of a controlled diet

I saw a couple of article that mentioned the use of budesonide for pancreatitis as well as for IBD so I was hoping maybe someone had used this as a treatment. I liked the idea that the budesonide was not as systemic as the prednisolone but if it doesn't work as well then it would be better to use the pred and raise the insulin dosages. I will ask the vet what they think, but I always like to have a good deal of information and understanding of treatment before taking any vet's advice.
 
Our specfPLI came back at 51. I am wondering if I need to explore steroid options as well. Nothing else has really worked so far. I wonder if your score of 50 was a fluke somehow. It would really surprise me to have no symptoms at 50 but I don't know how linearly correlated symptoms are with the score.
 
SpecklesandMe said:
Our specfPLI came back at 51. I am wondering if I need to explore steroid options as well. Nothing else has really worked so far. I wonder if your score of 50 was a fluke somehow. It would really surprise me to have no symptoms at 50 but I don't know how linearly correlated symptoms are with the score.
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Actually this was the second one I had done. The first was near the beginning of the year and Tuxie was not having an episode at that time. I thought because it was done non-fasting rather than fasting that is usually required, that it may have been falsely high. Tuxie had no signs of pancreatitis...no inappetance, no weight loss, no vomiting, no lethargy, ate well and acted basically normal. I chose to have the first one done since the U/S had shown orgamomegaly...inflammed pancreas, kidneys and adrenals and his glucose numbers were not even close to regulated. The second fPLI test I had done was just a few days ago at the time of a minor episode with vomitting and inappetance, which subsided with one 200ml Sub Q fluid and one shot of cerenia.

His lack of symptoms is very confusing for me and both vets at the clinic I deal with. I had the Feline TLI done (Gastrointestinal Function Lab, Texas) at the same time as the second specific fPLI and it came back very high 482 with reference range of 12-82. This again is indicitive of pancreatitis.

I am having a LDDS test done to rule out Cushing's before I decide to start the steroid treatment. The vet who did the U/S said the results were consisitent with Cushing's. I did have an oral HDDS test done and it came back as negative, but the LDDS test is supposed to be more accurate.
 
Tuxedo Mom said:
Actually this was the second one I had done. The first was near the beginning of the year and Tuxie was not having an episode at that time. I thought because it was done non-fasting rather than fasting that is usually required, that it may have been falsely high. Tuxie had no signs of pancreatitis...no inappetance, no weight loss, no vomiting, no lethargy, ate well and acted basically normal. I chose to have the first one done since the U/S had shown orgamomegaly...inflammed pancreas, kidneys and adrenals and his glucose numbers were not even close to regulated. The second fPLI test I had done was just a few days ago at the time of a minor episode with vomitting and inappetance, which subsided with one 200ml Sub Q fluid and one shot of cerenia.

His lack of symptoms is very confusing for me and both vets at the clinic I deal with. I had the Feline TLI done (Gastrointestinal Function Lab, Texas) at the same time as the second specific fPLI and it came back very high 482 with reference range of 12-82. This again is indicitive of pancreatitis.

I am having a LDDS test done to rule out Cushing's before I decide to start the steroid treatment. The vet who did the U/S said the results were consisitent with Cushing's. I did have an oral HDDS test done and it came back as negative, but the LDDS test is supposed to be more accurate.
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Seems like Cushings might explain it? We are also suspected Cushings but the U/S they did wasn't high res enough to see the adrenals. I am hoping my boy rallies and if he does we will eventually do the LDDS.
 
SpecklesandMe said:
Seems like Cushings might explain it? We are also suspected Cushings but the U/S they did wasn't high res enough to see the adrenals. I am hoping my boy rallies and if he does we will eventually do the LDDS.
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I know most vets don't even consider Cushing's because it is considered so rare. But years ago acromegaly was considered rare in cats and now it is shown to be much more prevelant than previously thought. The U/S I had was only able to properly visualize one adrenal, but with the organomegaly the attending vet gave a subjective opinion of adrenal based Cushing's. The oral HDDS showed that it was definitely not adrenal based since Tuxie had full suppression. I am having the LDDS done next week, but am worried about the results being off since Tuxie is a very high stress cat. I will be taking him in for the first blood draw and injection, taking him home and then bringing him back for the 2 follow-up blood draws.

I am very sorry to see that you are having such a hard time with the pancreatitis, in spite of all the medications and treatments that you are doing. I wish I could offer some words of wisdom, but all I can offer is prayers and ((hugs)) for a recovery back to normal. I can only imagine how stressed you must be with the symptoms lasting so long.

(( bighug: :bighug: ))))
 
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Thank you so much. Please let us know how the LDDS turns out. I just spoke to our vet about starting a steroid. He said that we can try prednisolone on Tues. Will see how that goes.
 
SpecklesandMe said:
Thank you so much. Please let us know how the LDDS turns out. I just spoke to our vet about starting a steroid. He said that we can try prednisolone on Tues. Will see how that goes.
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I talked with my vet earlier and we discussed whether doing the LDDS test or another U/S would be best. Since Tuxie is very prone to stress and just being put in the carrier and taken to the vet can cause him to roll into a ball and pee himeslf, we felt that the stress could affect the LDDS test results, so we are going with the U/S next Friday and see how the organomegaly is doing. The vet did talk with an internalist and with the fPLI and TLI numbers so high, they advised treating the pancreatitis first and factor in possible Cushing's depending on the results of the second U/S. The vet wants to use the prednisolone since he has never used budesonide on cats for pancreatitis and is not comfortable starting with that. So either tomorrow or Tuesday I will be picking up some pred for Tuxie,

His suggestion is to do a treatment program for 3 weeks then redo the specific fPLI and see if there is any improvement. I know that steroids are often used in pancreatitis and with Speckles having such a hard time recovering from this episode it may be the best approach. I asked the vet why Tuxie was not totally sick with such numbers and basically he said it came down to ECID, not in those words but still the same. Some cats can have lower fPLI numbers and be very sick and others, like Tuxie, are more "resilient" and only have minor attacks. But at the same time there is still damage being done, so treatment is necessary.

I hope the prednisolone helps with Speckles and he can start seeing some good improvement. It is so hard to see our furkids sick. :bighug:
 
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Prednisone gave my cat diabetes so I'd be really careful about that, everybody here on the forum recommended the budesonide but my cat has inflammatory bowel disease not pancreatitis.
 
dana moore said:
Prednisone gave my cat diabetes so I'd be really careful about that, everybody here on the forum recommended the budesonide but my cat has inflammatory bowel disease not pancreatitis.
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Budesonide is the best steroid for IBD cats, but it is not well known how well it works on feline pancreatitis. My kitty has been an unregulated diabetic for over 9 months, so the worst that could happen is that I may have to increase his insulin dose. However if the chronic pancreatitis can be brought under control. it may be easier to get him regulated. It is a catch 22 situation, but both conditions are causing more harm as more time passes. :(
 
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