2/28 Morris AMPS 371 Need Help With Dose on Steroids

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Brenda and Morris

Brenda and Morris

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Last Post: viewtopic.php?f=9&t=6864

I apologize in advance for the long post, just trying to recap what has happened since my last post. I haven't posted in over a week....Morris has just been too sick and me too depressed to inflict on anyone. His numbers have been wonderful, all green and blue on a very small .25u dose. The problem lies with his struggle with IBD or lymphoma, only a biopsy would tell for sure but I chose not to go down that road. I came very close several times in the last week to letting him go but decided to give it one more shot with my old vet to try and get her to prescribe the budesonide and bupe for pain.

We had a great visit with the vet on Friday and she agreed to script the budesonide and do whatever else I want since she is thinking in terms of it being a hospice situation at this point...I don't agree, I want him to get better...as far as I know, if it's IBD, that's NOT a death sentence. She asked to keep him for awhile to try and squeeze him in for an ultrasound, which I agreed to...that was at 9:30 a.m. Around 3 p.m., my normal time to give him a nadir test, I remembered that he really hadn't eaten more than a few licks of food that morning so I called and asked if he was done or if not whether I could come and test him. They said sure...so I went back over there and his BG was 34! I had some dry Temptations with me and gave them and then I asked it they had anything high carb...they gave me sone MD dry and he gobbled it up. I hate to think what might have happened if I didn't go over there when I did.

Anyway, she got to his ultrasound at 6 pm and when I picked him up she said that everything looked great on the U/S, no enlarged organs, kidneys and spleen OK, even looked at his heart and that looks great. We came home with the script for budesonide and some bupe. It was too late to order the budesonide online from the compounding pharmacy so the earliest it could be shipped is Monday and I would receive it on Wed. I got to thinking that's an awful long time to go without so Saturday I asked to come back in for a shot of steroids to tide him over until they come. They gave him dexamethasone and I also got one to take home in case he needs it today...the dex lasts 12-24 hours.

I do not see any difference in him since the shot...he still has no appetite and is lethargic, not moving around very much. And his BGs immediately shot up to the 300's. I am just wondering how much I can safely increase his insulin to cover the steroid spike. I hesitate to go up more than .25 (to .50u total) in case the dex wears off soon but don't know how long it will stay in his system. Then when he starts the budesonide it will be going up too so maybe I need to just gradually increase until I get him back below 200. Appreciate any insights or suggestions.
 
Dear Brenda & Morris--I have been holding my breath waiting to hear from you...So glad there was nothing on the ultrasound & that part sounds good..We have been praying for Morris that he has some appetite & feel better..Dont know about any of these meds, but try anything & everything you can at this point--You know we luv you & Morris & send our STRONGEST HEALING VInes to Him!!

Come on dear Morris, Moonie is very upset you dont feel good--Biggets HUGS~!!!!!!!!!
 
I can't advise about dose. Dexamethasone is the big gun among the steroids, and will likely have more impact than what you can expect to see down the road with the budesonide. I believe it will last in the system about three days (my lymphoma kitty gets a dex shot every 3rd day) and may linger a bit longer, but you should start to see the effect taper off. In my opinion, I would probably try to just ride out the dex effect rather than compensate with increased insulin - the insulin increase might kick in just as the dex wanes - but I would get input from exerienced dose advisors. The budesonide, which will be a longer term, but likely much gentler BG influencer, can be handled with more insulin, if needed.

I'm glad the u/s looked good. That is hopeful. You can't diagnose ibd or lymphoma from an ultrasound, but you would likely see some thickening or abnormality of the intestinal tract. IBD is not a death sentence (nor is lymphoma). Bear Man has had IBD for most of his life, and his civie brother Teddy has had lymphoma for over five years.
 
What a relief it is to see your posting. I have been watching for your post to know how Morris is doing.
The u/s results must have been good news for you, ruling out some issues.
I have nothing I can say about any of the dosing or meds, but I do hope Morris gets over this hurdle soon. As Linda said, neither issue are a death sentence, so let's keep pulling for Morris to get better day by day.

Lots of special scratches and cuddles for Morris.
 
Good news about the U/S Brenda....I have no info on the issues you are facing but I wanted to stop in and give you a big HUG and scritches for Morris....I hope things will get better real soon for you guys there.
Been missing you a lot this past week and I am so sorry for all that you have been through. So fortunate that you went to the vet's that day with your Temptations....such a good Mama....whew...great GREAT catch!!!
Sending prayers and healing vines to Morris boy....keep us posted on how is he feeling whenever you can. :YMHUG:
 
I don't know what is happening with him but he refused all food this morning and went into hiding, which he has not done in a long time...he usually only hides if he is very sick. I finally got him out and he seemed to be in pain so I gave him an injection of bupe along with the other dexamethasone injection they sent home with me. That was around noon and he has been just laying in his cat napper since then and appears to be very groggy. I got him up once and set him on the floor but he was kind of woozy and just laid down. I am hoping he isn't having a bad reaction to the bupe and/or the dex. I had also given him pepcid and cypro earlier, around 9 a.m.

If he is not getting a good response from the dex, does that mean that the budesonide will not work? The dex is stronger than the bude from what I gathered at the vet's office.
 
Brenda:

You may need to call your local ER and find out whether the meds should be given with a certain amount of time in between their administration to make sure they don't interact. Bupe can make your kitty woozy -- it's an opioid. The cypro can also magnify the sedative properties of other drugs.

Are you able to reach your vet today? I am concerned about the hiding.
 
Hi Brenda,
Im really sorry to hear about Morris and the struggles you two are experiencing right now.
WOW! I cant believe you got to the vet and found him at 34!!!! :shock: I admit I have not looked at your ss yet, but I assume everything has been fine since then?

Im wondering what makes them think ibd or lymphoma with everything good on the u/s? What kind of labs did you have done, in addition? Do you want to post some of the blood work in case anyone can comment on it? Latte has also been diagnosed with IBD/lymphoma, short of a biopsy because I did not care to put her through that with little difference in how we would treat.

Latte had a Dex shot, which helped her almost immediately. We started the pred less than 24hrs later. You could see the dex wear off and it took a while for the pred to start working really well...weeks, actually. It was explained to me that depending on the amount of imflammation, it could take a while. I dont know if dex *should* work no matter what.

Im not a medical expert, but I would think at this point it may be hard to determine if or which meds you have given today could be causing a reaction. I give cypro for appy stim and after the initial 'bing bang boom', it knocks Latte out and she appears somewhat depressed/lethargic. Its possible that is happening. If you have never given bup before, there could be a reaction there. I think I have heard some cats getting lethargic with it (I have yet to use it so I dont know from personal experience). If you are having reactions like that, Im not sure it would override the dex (which could take a few hrs for effect). you may need to wait until the bup and cypro wear off to get solid idea.

Do you have a plan with the vet? More tests? Sounds like you may start budesinide?

I would agree with Linda that you want to hold off on an increase quite yet, because the dex will wear off. When you start the bud, you may see a rising trend that you want to address. One will never know what will happen until you get into it.

Im sorry I cant be real helpful and give you solid answers...maybe just some things to think about? Could you post on health with attention to Jess? She may be able to give you better thoughts.

(((((((((brenda)))))))))) ((((((((((((((morris)))))))))))))))))
 
Also brenda-
If nausea and/or vomiting are an issue you may want to ask your vet about getting some ondansetron, possibly even some cerenia.
 
Morris only hid for a little while...he came out and was very groggy and could not walk very well. I'm afraid I didn't know the cypro would interact with the bupe. He has come out of it now but will not eat...took a few licks of tuna water and that is all. I will keep trying though. I will give nothing further until I see the vet tomorrow as the steroids don't seem to do anything for him as far as appetite...I'm afraid I was looking for a miracle. :sad:
 
Good luck with the vet tomorrow; I'll be thinking of you and Morris.

I hope you can get Morris to eat or even drink some more of the tuna water.
 
Glad to see you posting again Brenda! I have been worried about you & your Morris! Glad to hear that the u/s came back clear. Sorry to hear about all the hiding & groggieness he has been having though! Good luck with the vet tomorrow! Hope you get things sorted out for your Morris!!

:YMHUG:
 
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