IBD and Diabetes Advice Needed

[Bella & Liz]

Hello, my cat Bella was diagnosed with IBD/Lymphoma (got ultrasound but not biopsy to 100% confirm what it is) and was put on prednisone for about 2 months. She gained weight (her low was 6 pounds) and overall was seeming to do rather well on the steroids. However after those 2 months she started peeing outside the litterbox again and drinking tons of water. Turns out she had an infection and high blood glucose. The vet treated her with antiobtiocs and took her completely off the steroid and we began treating her diabetes with prozinc.

Now for the past month that she has been receiving insulin she has been doing really well, gaining more weight, seeming more active, etc.(she runs pretty low so she will often go quite awhile without insulin... I know I tend to be a bit to careful and should probably give it more often though). However over the past week or so she has started going poop outside her litterbox, which either means shes just being a punk, or she isnt feeling great.

Does anyone have any experience managing IBD without predisone? Should I request she go back on it? She doesnt throw up or have any loose stool really. I do give her B12 every 2 weeks which the vet recommended, and I just ordered some probiotics because I heard it could help? Any advice would be wonderful, thanks!

 

[Tracey&Jones (GA)]

Jones was on prednisolone but some have used budesonide instead. It is actually what made him diabetic.

I am tagging Wendy has she has dealt with using budesonde. @Wendy&Neko

 

[Bella & Liz]

Thanks for tagging someone, hopefully I get some help soon!

 

[Wendy&Neko]

My girl Neko was on budesonide because her heart could not handle prednisolone. It did not impact her blood sugar. But every cat is different. Worth a discussion with your vet.

 

[Tomlin]

Ditto what Wendy mentioned. Budesonide is supposed to work well for IBD with less of the issues that Pred can have. Just clarify it's only IBD because if the pancreas, gallbladder (triaditis) are involved, the Budesonide most likely will not be a good choice. My little man has Pancreatitis & also a question of Addison's, so Budesonide is not an option as it will not help because of these issues.

 

[Chachi's Mom]

My Chachi has IBD. He has been on Prednisolone and Cerenia for almost two years. I was never given another option. The more I read, I'm convinced the Prednisolone is the reason behind Chachi's Diabetes. He was taking 2.5 mg every day and now we are trying every other day to see if we can wean off or down some. I will research the Budesonide and talk to his Vet. Thanks all!

 

[Tomlin]

Hi Chachi's Mom. It could be the issue but not always. Injectable steroids are more often a definite issue. With that being said, just please make sure Chachi's pancreas etc aren't involved & also go very slow with the process of reducing the dose. I've been told & unfortunately, also experienced what seemed like a successful dose reduction & it wasn't. Inflammation can take some time so give it a few weeks on a reduced dose to make sure all is really well before reducing it again. I hope Budesonide is an option for Chachi & that solves your issue .

 

[Tomlin]

My Chachi has IBD. He has been on Prednisolone and Cerenia for almost two years. I was never given another option. The more I read, I'm convinced the Prednisolone is the reason behind Chachi's Diabetes. He was taking 2.5 mg every day and now we are trying every other day to see if we can wean off or down some. I will research the Budesonide and talk to his Vet. Thanks all!

I forgot to add, when my boys DM was diagnosed, my local vet reached out to a local "specialist" while waiting to hear from the vets working with us from the Universities. The specialist immediately jumped on the pred & said take him off of it, he's probably just got IBD. My vet immediately corrected her & told her he DEFINITELY has chronic pancreatitis diagnosed by multiple ways including university/specialist clinical, ultrasound, labs from Texas A&M (thats where the GI labs are sent) & that he's failed repeated attempts over the years of significantly reducing the dose of Pred. Sure enough, the experts from the University's concurred. It's not uncommon for vets to diagnose felines with IBD or pancreatitis & completely miss the fact that one may be the major issue but often there are multiple issues going on. Google "triaditis". I only mention because it makes a difference in how you manage them.

Look forward to hearing how Chachi does!!

 

[Chachi's Mom]

I forgot to add, when my boys DM was diagnosed, my local vet reached out to a local "specialist" while waiting to hear from the vets working with us from the Universities. The specialist immediately jumped on the pred & said take him off of it, he's probably just got IBD. My vet immediately corrected her & told her he DEFINITELY has chronic pancreatitis diagnosed by multiple ways including university/specialist clinical, ultrasound, labs from Texas A&M (thats where the GI labs are sent) & that he's failed repeated attempts over the years of significantly reducing the dose of Pred. Sure enough, the experts from the University's concurred. It's not uncommon for vets to diagnose felines with IBD or pancreatitis & completely miss the fact that one may be the major issue but often there are multiple issues going on. Google "triaditis". I only mention because it makes a difference in how you manage them.

Look forward to hearing how Chachi does!!

I will talk to his Vet. He was just tested a few days ago for all. She told me his Kidneys and all are fine but blood sugar was high 580 and here we are She never mentioned Pancreatitis but now I'm not sure if I've been given all info. Thank you so much!

 

[Tomlin]

How did they test him for IBD? What were his symptoms? I was recently told by one of my University vets that inflammation can result in an increase in glucose. I wonder if that it is what was going on with Chachi? If so, if it is just IBD, maybe once it comes down Chachi's glucose will do the same.

Just an FYI-There is a blood test (preferably done fasting) called fPLI (Feline Pancreatic Lipase Immunoreactivity) & its gets sent out to the lab to determine if there is pancreatitis. There is also the SNAP fPL-IDEXX that can be done in the office & you get results within a few minutes, but the fPLI lab should still be sent out. The fPLI is highly reliable in moderate to significant pancreatitis, more difficult read with mild, but still the most reliable test to check for it. Check to see if this was done.

Best of luck! I hope this turns out to be easy---or somewhat easy

 

[Chachi's Mom]

How did they test him for IBD? What were his symptoms? I was recently told by one of my University vets that inflammation can result in an increase in glucose. I wonder if that it is what was going on with Chachi? If so, if it is just IBD, maybe once it comes down Chachi's glucose will do the same.

Just an FYI-There is a blood test (preferably done fasting) called fPLI (Feline Pancreatic Lipase Immunoreactivity) & its gets sent out to the lab to determine if there is pancreatitis. There is also the SNAP fPL-IDEXX that can be done in the office & you get results within a few minutes, but the fPLI lab should still be sent out. The fPLI is highly reliable in moderate to significant pancreatitis, more difficult read with mild, but still the most reliable test to check for it. Check to see if this was done.

Best of luck! I hope this turns out to be easy---or somewhat easy [/QUO

Chach was a rescue about 3 years ago. 6 months after he came to live with me he began vomiting pretty regular with occasional diarrhea. He also started urinating on rugs around the house. They tested him for a UTI and gave him antibiotics. 2 weeks later he was better on the outside-the-box urination but still vomiting. Occasionally he still has flare ups with outside -the-box urinating and they gave him gabapentin for bladder spasms (his tests showed negative for UTI that time). He doesn't urinate around the house any longer, thank goodness but I keep a washer pan with a clean towel beside his kitty box and when he has issue now that is where he goes pee pee and when he does I know something is up and I can keep eye out for blood and such.
For the IBD, They ran blood work, sonograms, xrays all kinds of stuff then $4000.00 later decided he had IBD and we started treating with Pred and Cerenia. He has been on both for aprox 1 1/2 to 2 years. His vomiting and diarrhea is almost in non existence now but now I treat him for constipation due to the Prednisolone. His blood sugar tested normal about a year ago and kidney values still run at the high end of normal since first testing couple years ago.
I will ask the vet about the fPLI and SNAP fPL-IDEXX tests to see if he can be transferred from Pred to Budesonide. Right now we are trying to change from daily pill to every other day. Hope that goes well for the little fella.

 

[Chachi's Mom]

How did they test him for IBD? What were his symptoms? I was recently told by one of my University vets that inflammation can result in an increase in glucose. I wonder if that it is what was going on with Chachi? If so, if it is just IBD, maybe once it comes down Chachi's glucose will do the same.

Just an FYI-There is a blood test (preferably done fasting) called fPLI (Feline Pancreatic Lipase Immunoreactivity) & its gets sent out to the lab to determine if there is pancreatitis. There is also the SNAP fPL-IDEXX that can be done in the office & you get results within a few minutes, but the fPLI lab should still be sent out. The fPLI is highly reliable in moderate to significant pancreatitis, more difficult read with mild, but still the most reliable test to check for it. Check to see if this was done.

Best of luck! I hope this turns out to be easy---or somewhat easy

OOps, I made a boo boo with my post earlier I think
Chach was a rescue about 3 years ago. 6 months after he came to live with me he began vomiting pretty regular with occasional diarrhea. He also started urinating on rugs around the house. They tested him for a UTI and gave him antibiotics. 2 weeks later he was better on the outside-the-box urination but still vomiting. Occasionally he still has flare ups with outside -the-box urinating and they gave him gabapentin for bladder spasms (his tests showed negative for UTI that time). He doesn't urinate around the house any longer, thank goodness but I keep a washer pan with a clean towel beside his kitty box and when he has issue now that is where he goes pee pee and when he does I know something is up and I can keep eye out for blood and such.
For the IBD, They ran blood work, sonograms, xrays all kinds of stuff then $4000.00 later decided he had IBD and we started treating with Pred and Cerenia. He has been on both for aprox 1 1/2 to 2 years. His vomiting and diarrhea is almost in non existence now but now I treat him for constipation due to the Prednisolone. His blood sugar tested normal about a year ago and kidney values still run at the high end of normal since first testing couple years ago.
I will ask the vet about the fPLI and SNAP fPL-IDEXX tests to see if he can be transferred from Pred to Budesonide. Right now we are trying to change from daily pill to every other day. Hope that goes well for the little fella.

 

[Tomlin]

Poor little Coach!! Happy to hear they did extensive work up! I only ask because I've met several people & also had a good friend & a family member told their cats had pancreatitis or IBD or triaditis & when I asked how they diagnosed them, the basics used to determine one or any of these diagnosis weren't done! In one case I had to help with an appeal to the pet insurance company because the cat was labelled "pancreatitis" but wasn't! My family members vet said its common these days that if a cat is brought in vomiting, the get labelled without proper testing & time to figure out exactly what is going on. UGH.

Look forward to hearing a "he had a negative fPLI" !!! I also wish you the best of luck with the transition. I know I'm doing what I can with the Pred but very slowly, carefully & only as the specialist guides me to. Last thing poor man needs is a pancreatic episode .

 

[Tomlin]

Chach...my autocorrect renamed your cat "Coach"!

 

[Chachi's Mom]

Poor little Coach!! Happy to hear they did extensive work up! I only ask because I've met several people & also had a good friend & a family member told their cats had pancreatitis or IBD or triaditis & when I asked how they diagnosed them, the basics used to determine one or any of these diagnosis weren't done! In one case I had to help with an appeal to the pet insurance company because the cat was labelled "pancreatitis" but wasn't! My family members vet said its common these days that if a cat is brought in vomiting, the get labelled without proper testing & time to figure out exactly what is going on. UGH.

Look forward to hearing a "he had a negative fPLI" !!! I also wish you the best of luck with the transition. I know I'm doing what I can with the Pred but very slowly, carefully & only as the specialist guides me to. Last thing poor man needs is a pancreatic episode .

Thank you Amy, I know what you mean with the pred. slow and easy ....this whole ordeal has given me reason to doubt this Veterinary Hospital. I am going to research for a new Dr. and clinic.

 

[Tomlin]

I'm not sure where you live, but check to see if there is a University Vet program near you. They are such great places! Similar to human medicine, places like Cornell, Mayo Clinic, etc.....they have most of the top, extremely dedicated physicians/experts who, in addition to their clinical work, do research. They also get the opportunity to see a larger group of patients & the most challenging cases, including the ones that the smaller, local vets can't quite figure out or manage optimally. Even if its a distance, once you are connected, they will work with your local vet to help manage things unless you really need them.
I learned the hard way many years ago. I ended up at one of the local Emergency Clinics & also had to have mobile specialists do scans which was very expensive. When I ended up at the University, they commented on how the scans weren't bad for a mobile scan, but they needed to be repeated for better views using the latest scanner. The cost was substantially lower than using local specialty clinics--even for medications. Apparently, because they are part of a university, they get funding, & this allows them to provide lower cost services & meds. And just like a top University Hospital, they have specialists who work as a team--that is key with some of these GI issues!