cyclosprorine?

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Pandasmom

Pandasmom

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Hi,

Does anyone know if Cyclosporine can affect BG numbers?

Odie's complicated, IBD, chronic pancreatitis, diabetes, and currently some unknown pain at the base of his tail.

His BG numbers started edging up about 2-3 weeks ago, he was more lethargic, not wanting to eat, and not seeming very happy. Cyclosporine was added on May 29 (without a vet visit, I just went to talk to his vet, thought his IBD was acting up). June 1 his BG numbers jumped up. Have not been able to get them down much since. Buprenorphine was added June 9 after a vet visit (ultrasound, x-rays, blood work, exam all looked ok) discovered that the base of his tail hurt. No idea why.

He now does not seem to be in pain, but is pretty quiet (i'm guessing now from the buprenorphine making him a bit groggy). He's eating alright though and comes when called.

I'm not sure why his numbers are still up though.

He's currently on:

budesonide
cyclosporine
chlorambucil
pepcid
lantus
buprenorphine

Any ideas?
 
Why was the Cyclosporine added? I thought that was more for skin problems. I'm no expert or vet, so I could be wrong.

Sounds like Odie has most of the same things as Tucker, IBD, CP, FD... Tucker has a lot of cysts on his tail, those cause him pain and I cannot go near the area, but you would know if Odie had a cyst. Tucker's IBD could be different also, his presents with slow motility, he's needed enimas and surgery to remove stuck hairballs, sometimes cigar shape and length.

The Bupe is probably making him groggy. I use that as needed only.

I don't mean to be nosy, but what is the chlorambucil for? I'm wondering if I'm missing something for Tucker.

For his IBD, when it acts up he takes Flagyl (metronidazole). We did try budesonide but that didn't seem to help him. Since his March crash he takes Pred, IBD has been good since then and we have not used the injectible pepcid.
 
Tucker's IBD sounds different than Odie's.
Odie's main symptom is throwing up and then refusing to eat, then diarrhea sets in. He's been really hard to stabilize.

He's been on prednisone, it didn't work for him.
Tried adding tylosin, didn't help.
Switched to Dexasone, helped but not quite enough.
Added Tylosin back in, didn't help.
Added Chlorambucil (it's technically a chemo drug - I have to wear gloves to give it to him. He gets it every 48 hours. But it's supposed to help with inflammation)

He was doing fairly well on Dexasone, Chlorambucil, and Pepcid for several months.
Then the diabetes arrived in Feb 2010. His internal medicine vet figured it was caused by the Dex, so we gradually switched to Budesonide.

Budesonide + Chlorambucil + Pepcid didn't do too badly (which surprised us, really).

But then a few weeks ago he started feeling worse again, threw up a few times, stopped wanting to eat.

Added cyclosporine.

Both the Cyclosporine and Chlorambucil are immune-suppressants.
("Chlorambucil and cyclosporine are examples of drugs that reduce inflammation by suppressing the immune system."
- from http://www.halopets.com/pet-education/p ... -Cats.html )


Mixed in with all of this, there's been Mirtazapine (big-no-no), Cerenia, Torbugesic (no-no), Tramadol (BIG no-no), Codeine, Buprenorphine.

I'm probably missing some @-) It's been a rough (and expensive) year and a half!
 
Wow, you have been through it all. When I adopted Tucker in '05, I swore I paid for my vet's car with all the tests and the exploratory surgeries. I really hope you can find the right mix of meds for Odie.
 
tuckers mom said:
Wow, you have been through it all. When I adopted Tucker in '05, I swore I paid for my vet's car with all the tests and the exploratory surgeries. I really hope you can find the right mix of meds for Odie.
Click to expand...

Yeah, that sounds about right. :smile: Although I have to say that his internal medicine vet has been wonderful. We're in touch pretty much weekly, sometimes more often, trying to figure this out. She calls him her Problem Child :smile:

What do you feed Tucker?

Food has been another crazy battle. I've tried somewhere in the range of 75 types by now (including dry, wet, home-cooked, and raw). He's incredibly picky, and then even once we find something he'll eat, once he feels sick on it, he then associates it with feeling bad and refuses to eat it ever again. Sometimes I can sneak something he really liked back in a few months later, but it's iffy.

Never mind trying to find something that's low-carb, low-fat, low protein, novel protein source, and high-fiber, to meet all the restrictions. What in the world is *that*?!
He's currently liking "FF Shredded White Meat Chicken with garden greens". I know it's higher carb than desired (11%), but well it's the best I can do for right now!
 
For IBD, you might try switching to a raw food diet. That's helped a *lot* of kitties with the diarrheal form of IBD. (Raw food should be fine in cats with normal digestive systems, and may or may not be severely contra-indicated in cats with constipation issues. If you have other cats, one of which has constipation problems, please monitor their bowel movements carefully if you switch to a raw food diet.)

The other thing that helps a lot of IBD cats is B-12 injections. Impaired digestion can lead to inadequate absorption of B-12, which can further impair digestion. Most cats start with the TAMU protocol here and adjust it to their needs. You give B-12 injections sub-Q, just like insulin, and you can even use an insulin syringe to give it. You should be able to get a bottle of injectible B-12 from your vet, special order it through some pharmacies if your vet will give you a prescription, or you may be able to find it in your local feed store. My vet charges me about $12 for a bottle, and it lasted over a year.

You may also want to join YahooGroups feline IBD group, which may be of further help to you. Their first recommendations, however, will to try a raw food diet and the B-12 injections.
 
Among other things, Tucker is allergic to gluten. He once spent a few days in December '07 at the vet's clinic with "Fever of Unknown Origin" until I found out he was eating the corn cat litter that we had just switched to. An animal communicator told me about the litter he was eating :razz:

In May of '06 I did a phone consult with Dr. Lisa, from there I started removing the glutens and he went off insulin immediately, that was how we figured it out. He hasn't had a stuck hairball since, he's had a few huge ones, but he was able to get them up himself.

Tucker can only eat Fancy Feast Beef Feast or Savory Salmon Feast, sometimes Beef and Chicken Feast.

He got sick on Wellness grain free and EVO canned. I don't think he can tolerate anything that is slightly more fat than the FF. For treats, once in a while he gets Wellness Core dry a few kibbles, but very rarely and when I do that he takes Miralax the day of to be safe. Also for treats, freeze dried chicken treats or bonita flakes.

He can also have as a treat Solid Gold canned, that's pretty much all seafood. Best Feline Friends and Before Grain have been okay with him, but none of these I believe are a good food to feed all the time, so only for birthdays and holiday :)

As JJ mentioned, raw is a good idea, but Tucker was a dry food addict when I adopted him, he won't try raw although we have it out daily for Mr. Darcy, Tucker wont even eat deli meat. Also as she mentioned, Tucker gets a B12 shot about 1 every two weeks, his numbers always come down beautifully after a shot.
 
JJ & Gwyn said:
For IBD, you might try switching to a raw food diet. That's helped a *lot* of kitties with the diarrheal form of IBD.
Click to expand...

I would be reluctant to use a raw diet in a cat on so many immuno-suppressants, to be honest. I know other people have done it, but this cat is on three different immuno-suppressants, two of them pretty powerful (chlorambucil and cyclosporine). There has been no similar study in cats, but a study in dogs showed that dogs fed raw food were much more likely to harbor salmonella; although healthy animals can carry salmonella without issues, animals (and humans) who have compromised immune systems are at much higher risk of complications.

Odiesmom, it sounds like your kitty was doing well on the dexamethasone -- why not go back to it, and manage the diabetes around it? I had a very difficult-to-manage IBD kitty and when we hit the magic combo, we stuck to it and I dealt with the diabetes when it developed. Dex is also an anti-inflammatory and should help with his low back pain.
 
I said:
> For IBD, you might try switching to a raw food diet. That's helped a *lot* of kitties with the
> diarrheal form of IBD.

and Jess replied:
> I would be reluctant to use a raw diet in a cat on so many immuno-suppressants, to be honest.
> I know other people have done it, but this cat is on three different immuno-suppressants,
> two of them pretty powerful (chlorambucil and cyclosporine).

That's a really good point, and I hadn't thought about the immune-suppressants in combination with a raw food diet when I responded. Please ignore that suggestion.
 
Yeah, I tried to feed raw earlier on, he'd have none of it.

I have not wanted to try again now that his immune system is so suppressed. He's an indoor cat and has no contact with other animals... I'm trying to do what I can to make sure he doesn't catch something - I walk in the door and the first thing I do is scrub my hands, probably a good thing to do in any case, but I'm especially diligent with it now.

Switching back to Dex is an option and it may well come to that. The thing is that in the first few days on Budesonide, he really perked up - he was himself again, playing, running around... like I hadn't seen him since before he got sick a year and a half ago. But then he returned to his post-IBD "normal" of being pretty good, but more quiet and not really playful. So I was hoping that we'd somehow get back to the "real" normal again. I know he wasn't there with the Dex.

It's just so much juggling. I wish he could talk. Or that I could speak "meow" fluently.

Odiesmom
 
Just a quick FYI, but cyclosporin gave pancreatitis to Astrophe, so do be careful in a cat who is already prone to CP. ECID, of course, but...
 
I just found this site that's really interesting. It mentions cyclosporine's possible side effect of causing pancreatitis too..

http://www.2ndchance.info/inflambowelcat.htm

In stubborn cases, two other medications that disable the immune system are also used occasionally. They are cyclosporine and azathioprine, two powerful anti-cancer medications. They must be managed carefully with frequent laboratory tests of your cat's system. They have been known to cause pancreatitis, bone marrow and liver problems. Other similar powerful medications used to disable the immune system after organ transplants or cancer have also been used.
Click to expand...
 
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