IBD medication advice

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GregH

GregH

Member Since 2017
Hello. I posted recently in My Cat Moe about some problems i've had in controlling Moe's diabetes, which started in early November. Before November he seemed fine, he actually had dental work (resorption lesions) done in early August and he did not have any problems with that. After several visits to my local vet, we were referred to an internal medicine specialist to control his diabetes. She indicated that we're having trouble controlling diabetes because of something else going on. After an ultrasound we discovered thickening of the small intestine (2cm x 1xcm) with spots around it (that could be harmless, she said). After a physical examination of him, she also mentioned that moe's intestines seemed "ropey" and like there was "poo stuck in there".

Unfortunately we can't tell if its IBD, Small cell Lymphoma, or Carcinoma because it is impossible to biopsy unless undergoing exploratory surgery (which we are very hesistant about doing). We're treated Moe for ketones and trying to get his weight back up. It seems like he's not absorbing many nutrients and although he eats a lot his weight is down. The vet indicated 4 hours after he ate he still had a full stomach when she did the ultrasound.

We are considering trying to treat him for IBD even though we don't know that for sure by giving him steroids. Moe has been very difficult to regulate, especially recently. This morning his glucose was above 600, then at dinner time it was 90 after getting 2.5 units, for instance.

I would love to hear any advice on this subject, and what steroids/medications for IBD are the least likely to make Moe's diabetes worse.

Thanks very much.
 
Hi,
I understand how you are feeling--
My boy (17) has never had perfect tootsie roll poo but it was acceptable. He had a dental last summer and after that his poo became more and more runny and eventually water like. I went to very respected specialists and nothing was confirmed on blood work-
She wanted to do a biopsy and like you I was not too sure about sedating him. I spoke to me regular vet and I did tons of research and came up with all the possibilities that you did and he agreed to treat for IBD. SO I had given him 2.5 mg of pred and it did nothing. We upped it to 5mg 2x a day (my guy gets fluids as well for kidneys) well within a few days he went into heart failure in ICU in oxygen and the pred weakened his heart muscle.
The doctor gave us 2-4 weeks.... this was about 6 months ago!

He is now on budesonide which has helped his poo issue (although not as good as pred) but he is happy and bright and playful.
He gets 1mg of budesonide 1x a day and vetmedin 2x a day and depending on his resp. rate he generally gets 8mg lasix 2x a day (this is due to the heart damage from the pred. If needed he gets a appy stim and he gets ondansetron 2x a day and cerenia 1x a day.

I am going to tag @Wendy&Neko
She has vast knowledge regarding this issue.
This is my boy loving life!
IMG_0730.JPG
 
jayla-n-Drevon said:
Hi,
I understand how you are feeling--
My boy (17) has never had perfect tootsie roll poo but it was acceptable. He had a dental last summer and after that his poo became more and more runny and eventually water like. I went to very respected specialists and nothing was confirmed on blood work-
She wanted to do a biopsy and like you I was not too sure about sedating him. I spoke to me regular vet and I did tons of research and came up with all the possibilities that you did and he agreed to treat for IBD. SO I had given him 2.5 mg of pred and it did nothing. We upped it to 5mg 2x a day (my guy gets fluids as well for kidneys) well within a few days he went into heart failure in ICU in oxygen and the pred weakened his heart muscle.
The doctor gave us 2-4 weeks.... this was about 6 months ago!

He is now on budesonide which has helped his poo issue (although not as good as pred) but he is happy and bright and playful.
He gets 1mg of budesonide 1x a day and vetmedin 2x a day and depending on his resp. rate he generally gets 8mg lasix 2x a day (this is due to the heart damage from the pred. If needed he gets a appy stim and he gets ondansetron 2x a day and cerenia 1x a day.

I am going to tag @Wendy&Neko
She has vast knowledge regarding this issue.
This is my boy loving life!
View attachment 25615
Click to expand...
Great picture, Jayla! Love it!:bighug:
 
Larry and Kitties said:
I have had three cats on budesinide. Two were diabetic. It did help a lot
Click to expand...
Wow you have a lot of kitties:) What were you using the budesinide for on your kitties? I'm looking into it for skin allergies either from food or environemental allergies. My vet has never head of it.
 
Thank you all. Jayla, that is such a cute picture!

We started Moe on prednisolone last Friday (5mg 1x a day) just because of availability of budesinide--The doctor said it would take several days to get it from a compounding pharamacy via mail-order and we really wanted to start treatment right away to get him feeling better. We may still switch yet. She redid the ultrasound and noted that the thickening seemed longer and thinner than what she saw before. She seemed much more optimistic about it when we talked with her. She still thinks something is going on in his gut though where the steroid comes into play. She actually felt like even with prednisolone we would start to see his numbers come down after a few days.

I think we have the ketones down (he got them last week and the vet gave us fluids to give him every morning, and they were gone as of last Friday) but I'm still fighting some high glucose levels he has in the evening at preshot values (500-600). The morning preshot values seem to be much much better (200-300) for some reason. His attitude has been a bit off. He'll come up for a bit but doesn't like to come upstairs to our bedroom like he used to. He mostly hangs out in the kitchen all the time. Which tells me he thinks he's hungry but I'm scared to give him more food when his levels are super high.

That's where we are at. This is all so hard to figure out. I thought the prednisolone was doing better over the weekend but we had to go back to work today and the worst time to observe him is right after he's fed in the evenings because he's fighting getting the glucose levels down. I think overall he is feeling better but I'd like him to gain more weight (we're already feeding him extra from what he used to get) but he still seems hungry all the time, and once again, hangs out mostly either on the kitchen counter or under the dining room table.

I wish I could have my old Moe's attitude back.
 
I talked to the doctor on the phone today. As some of you had mentioned, she said we aren't feeding Moe enough. So I've increased his food as of this evening and I'm scared what his levels will be. Pre-shot tonight it was 560. I also increased his insulin a little bit. Fingers crossed.
 
Oh and also I have a prescription for budesinide on its way, I should get it mid-next week and we will switch from prednisolone to that when we get it.
 
If you haven't visited http://www.ibdkitties.net/ yet, there, lots of good info over there. I am glad you are getting the budesonide. It should help the blood sugars. It didn't seem to impact Neko's blood glucose. I got my budesonide compounded at the local compounding pharmacy within a day - fish flavour. :cool: We also didn't do a biopsy to determine IBD vs lymphoma because of her heart condition, though the ultrasound looked more like lymphoma and that's what I suspect she had.

With recent ketones in the picture, you do want to keep the number of calories up.
 
Started budesonide tonight--it came in the mail last night. I'm hoping it will erase the > 500 levels from the spreadsheet going forward. Does it also help for lymphoma? The doctor isn't sure the prednisolone was helping, but didn't think it was hurting either.

Moe is HUNGRY. ALL THE TIME, and extremely whiney about it. And he doesn't seem to be either gaining or losing weight back no matter how much i feed him. Should switching from prednisolone to budesonide help with that? We need him to gain some weight back, and its been about 5 days since i almost doubled his food intake. He's been hovering around 8.9 lbs for the past week. (He was 9.2 lbs the week before). His attitude does seem better though when you can get him to think about something other than food.
 
Hi
The budesonide has a "loading dose "
Ricos cardio had me start it while still on pred.
I'm not sure you will see the difference for a week or so.
Rico has gained weight on the budesonide.
A little too much :rolleyes:
His poo is sometimes firm but not always like when he was on pred.
Rico seems happier on the budesonide as well. :bighug:
 
My Neko was never on prednisilone, due to her heart condition. We didn't do a loading dose for budesonide either. But within a couple days of starting budesonide, her foamy vomits stopped. When she got a repeat ultrasound a couple months later, the thickness of her bowel walls had gone down 40%, so it was definitely helping her. So the budesonide did help some, but not as much as pred might have it she'd been able to take it.

Contrast my other cat with IBD/lymphoma (when it rains it pours here :rolleyes:) who is on prednisilone. Again probably lymphoma but no biopsy. His latest ultrasound shows bowel walls back to normal size and lymph nodes shrunk, so he's in remission. Prednisilone does do a better job, at least it did in him, but you do have to work around other conditions if the kitty has them. He also gets a long more "hungry" on pred than Neko ever was on budesonide. She did not gain weight, he did.
 
Thanks, this information helps. The numbers so far seem to be better on budesonide. Moe's poo is more runny than it is firm for sure. He just proved that an hour ago and it stinks pretty badly too. It's not always quite that runny but I doubt its very firm. I wonder if the high numbers lately have anything to do with that. I'm trying to get them down but its tough, we're already up to 2.5 units now and I know now he's on budesonide its likely he could go low enough i have to lower his dose.

I wonder if the prednisolone wasn't helping him (he was on it for a week and she wasn't convinced it was helping), if the budesonide will be more or less likely to work. His attitude does seem better though, I just need him to gain some damn weight. It's frustating when the scale doesn't move no matter how much you feed him.
 
Rico has been on the budesonide for about 7 months and he will still have some pretty runny poo but at least 50% of the time is is formed but loose and the smell is still pungent to say the least. But he is in good spirits on it and knowing it does not have the bad side effects helps me not to freak out by giving it to him. If you kitty is anything like mine he will plump up in no time :)
Rico went from his sleek 12-13 pounds to 15-16 :eek:
 
Jayla, what food and how much do you feed him? I'm up to 3/4 a can of MD plus 1/2 a can of fancy feast elegant medley (in a savory sauce) two times per day, plus I feed him extra at times when he begs for food. Most of it seems to pass right through him. Also I take the budesonide I got from the compounding pharmacy and put a little butter around it to help him swallow it, seems to make the pilling process go a little more smoothly.
 
I dab Ricos meds in butter as well it makes a big difference ... I have food ready for him after the pills to make sure it doesn't get stuck:eek:
I have Rico and Dre and I have always free fed. So when Dre was dx with diabetes I had to rethink how to make this work but the short version is they still have food out all the time (they are 17 and 18 this summer)
I put pure bites chicken and wild side salmon in the vita mix and blend it into almost dust and they nibble on that throughout the day-

They get fresh canned food in the morning-when I get home from work and before bed.....sometimes even thru the night if they wake me for it.
If Dre wakes me I know his bg is low-if Rico does (which is rare) he is really hungry. I do think the budesonide has given him a bigger appetite. (and belly)
The budesonide should kick in and help firm the poo--I would give it a few weeks.

Mine rarely if ever finish the canned food, my outside cat is even fussy!
I guess the really short answer is they always have food out which in turn seems to make them eat less.... (Dre has lost a pound since switching to wet-Rico only gained when put on budesonide.)
Here is a example of the varieties of food I have on hand for the fussy boys--and a few cabinets full:oops: (FF-MAX cat-Precise-Sheba-Evolve-Weruva-Tuna-Daves-Ziwi-stella and chewys freeze dried)
There is a semi moist food called "Waggers" that is about 10% carb that might be a option for you to leave out for nibbles.
food.jpg
 
Thanks for the info!

I weighed Moe right after eating tonight and he is up from 8 lbs 14.0 oz last time to 9 lbs 5.6 oz tonight! I'm encouraged but really hoping he'll actually have gained some after the next time he uses the litter box (The 8 lbs 14.0 oz was right after visiting the litter box last time). His body shape still looks too thin however, especially around his waist in back.

The budesonide seems to be bringing his numbers back down a bit. And it seems that his attitude continues to improve, and he's less hungry and whiney about it than he was on prednisolone.
 
Well forget that. An hour after I posted he went to the litter box so I weighed him when he came back... 8 lbs 13oz! Really he loses over half a pound from one trip to the litter box?! I was flat our diarrhea this time. Tonight no diarrhea yet but he is 8lbs 15.6oz tonight. I'm keeping my fingers crossed.
 
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