Looking for Information on Budesonide and Diabetes

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Laura Nels

Laura Nels

Member Since 2015
My cat Vivian has been on prednisolone for several months to treat diarrhea associated with intestinal disease. She consequently developed diabetes and has been on Lantus since June. The plan had been to replace pred with chlorambucil in the hopes her diabetes would go into remission. Unfortunately the chlormabucil did little more for Vivian than to make her feel unwell, and the tapering of pred resulted in a recurrence of diarrhea and associated symptoms. She has had to resume her full dose of pred and even now I'm not sure if it is having the therapeutic effect it once did. We're in a pickle. I have asked my vet about Budesonide a couple of times, finally she looked it up in her vet meds manual and emailed me a copy, she said she would check with internal med specialist about this med, but that's as far as we've gotten. I've read great things about Budesonide in terms of effectively treating intestinal disease without the side effect of raising BG. I have also read that it can also raise BG, the effects on cats aren't well know, and that it can be prohibitively expensive. What I'm looking for her is some anecdotal information from those who have had success using Budesonide with their diabetic cats, success being defined as adequately managing intestinal inflammation and not raising BG #s - anyone have success getting their steroid induced diabetic cat into remission on this drug? What does it cost? I am hoping to gather this information and take it to my vet so we can perhaps transition Vivian onto Budesonide. Meanwhile I'm going to do some BG testing since Vivian has gone back up to full dose pred and see what the numbers look like. She's not feeling too great.
thank you
Laura
P.S. I have looked at IBDKitties and read their general guidelines on the use, pros, cons of Budesonide, can't follow them on FB b/c I don't do FB
 
That was the same thing that my vet told me. I have two cats on it and since neither one are diabetic, that was my concern about putting them on it. Both have responded well to it.
 
Hello.
I was just using budesonide and prednisolone at the same time as mine had ibd/possible lymphoma.
Yes her bg went up but you have to treat the ibd first, then the diabetes. The spikes weren't too high though.

One of the things that worked for a while was Clay. I put it in empty capsules as mine wouldn't eat her food when meds were involved.
Diet is key .... and if you can get your cat to eat a novel protein, that can really help.
I tried everything but mine did not want to eat what would make her feel better.
I just lost her because she was in a lot of pain.

ibd guidelines
cat nutrition

You will also want your vet to give you ondansetron for nausea.
Ibd causes a lot of nausea and inappetance so having a appy stimulant helps too, like Cyproheptadine.
You give it 30 minutes after the ondansetron.
 
I think I have had four diabetic cats on budesonide. For two I really did not notice any change in BG/required insulin. One required a small increase in insulin. The fourth, MurrFee is unclear. He is on 25 units Levemir twice daily
 
Seems like one of the many meds that works for some cats, not for others and you don't know until you try. The specialist told my primary vet that when a cat isn't tolerating pred, or the condition isn't resolving, she goes to chlorambucil before budesonide. Unfortunately for Vivian we already went to chlorambucil when pred wasn't tolerated and it just made her feel sick, in fact made diarrhea worse. So I guess you've got to try if you really want the right answer, I just don't want to make Vivian feel sicker instead of better. Not sure how many more feeling sicker events she can tolerate. Waiting for specialist's "plan B" response now...or would that be plan C - I've lost count
 
My cat had steroid-induced diabetes. She had gotten a shot of pred for chronic diarrhea (IBD). She went OTJ in June before I began using Budesonide. When her diarrhea came back, I asked the vet for Budesonide instead. She has been on it for 2.5 weeks and her BG is still normal. I used to hear gurgling noises coming from her gut, but since she's been on the B, there are no more noises. She's still nauseous, so I'm taking her to the vet tomorrow to ask about giving her Cerenia.

I got it compounded into a liquid, which should last about 5 weeks. It cost $50. I live in LA so it may be cheaper somewhere else. Next time I'm going to order the pills from Roadrunner pharmacy. I was just in a hurry to start using it so I had the vet call in the scrip to a local pharmacy.

Have you tried giving her pumpkin purée or oatmeal? The fiber helps bulk up the stool. Marshmallow hated oatmeal but loves pumpkin. I freeze pumpkin in ice cube trays then put the cubes in a bag in the freezer. Every night I defrost a cube and she sits at my feet waiting for it. You can also try plain yogurt for the probiotics. Fortiflora also helps some kitties with diarrhea (didn't help Marsh). Some people have had really good luck with Animal Essentials Plant Enzymes and Probiotics. I just ordered some from Amazon. It's also available from Chewy.com.

Why is your vet dragging her feet on giving Vivian Budesonide? Can you go to another vet? Good luck and let us know what happens.
 
My vet is very experienced and confident at handling the straight forward pet stuff - even surgeries. But when it comes to situations where the cat doesn't respond to traditional measures or has a recurring or complex problem she is pretty open about saying she has done what she knows how to do, time to see the specialist - this happened with both of my cats this winter and she really didn't have the equipment or specialized knowledge necessary to do the diagnostics they required: doing and reading CT, ultrasound, rhinoscopy, biopsy...she has a pretty close relationship with this specialty animal hospital (90 minutes away!) so she makes a lot of referrals to them. I guess the good part is that, after having spent thousands of $$ in diagnostics at this place, they are willing now to do phone and email consults about trouble shooting through the options when one med or approach isn't working. Since both of my cats have been to this place, she consults them almost every time a med change or adjustment having to do with the condition they diagnosed is concerned. Odd set-up but it saves me the 3 hour round trips, as long as they're willing to do it. They even order tests that are done at my local clinic and results forwarded. That's what is going on with the budesonide right now. There is progress being made, but since the specialist said she recommends chlorambucil, we're waiting to hear how she responds to, yes but chlorambucil doesn't help...
Oddly enough I checked Vivian's BG last night before insulin and it was at 69, even though she's back up to full dose pred, not sure if she's just not eating much or if the transition to low carb food (not quite complete) is making a difference. I didn't give insulin, will check again this a.m.
This is a point of disagreement between me and the vet - she scolds me for doing BG "spot checks" between curves every couple weeks - so I just don't tell her when I do them.
 
That's great that you don't have to go to the specialist and they'll let you consult remotely. Hopefully they'll get on board with giving her budesonide soon! Is Vivian throwing up? Is she on anything for nausea? That might make her feel a little better. My vet is starting Marshmallow on Cerenia today because she keeps licking her lips and burping, even though she's not throwing up.

And I would do the same thing about checking her BG at home even if the vet doesn't agree. ;)

Changing to the low carb food can definitely be the reason her BG was low last night. That's great that her number was so low. Hopefully she's getting the diabetes under control and then you can just concentrate on IBD.
 
One thing that Vivian has in her corner is that she normally has a pretty steady - though sometimes small - appetite and doesn't have a lot of nausea.
I think Chlorambucil upset her stomach, and if it had done anything for her intestines I would likely have kept her on it and added something like Cerenia.
I have found 2 or 3 little "presents" in the last month, but I also have another cat Willis on quite a high dose of cyclosporine which can cause nausea.
So not sure who's leaving the presents. She takes only pred,Lantus, B-12 to date I have been hesitant to add to many more things to the mix as I already feel like I'm always coming at her with something: pricking her ear, injecting her, pilling her. Oddly enough my cat Willis has recently been on Cerenia, not for nausea but b/c it is thought also to have anti-inflammatory properties, so you may be doing your cat a double favor. At first they were selling me syringes full of it at about $10 each, then they tried to sell me a vial of it and my own syringes and I was like wait a minute, isn't this stuff available in pill form? In fact it is, and for a lot less money than injections!
 
Laura Nels said:
I already feel like I'm always coming at her with something
Click to expand...

I totally know what you mean. I feel the same way. I just realized that B12 also can help nausea and Marshmallow had a blood test for B12 today. If it turns out that she needs B12, I may give her just B12 and not the Cerenia and see if that's enough to help her nausea. I don't want to over-medicate her or be constantly shoving things down her throat if she doesn't need them all.

I've also ordered some new probiotics that seem to help some IBD kitties. I'm trying to not go overboard since especially with IBD kitties you can't make too many changes at once since that can upset their bellies. So: just starting with either the B12 or Cerenia when I get the blood test back. Then in another week or two I'll start the probiotics. Sigh. So many things to juggle. Poor little furballs.

I've learned a lot from the IBD Kitties FB page. If I were you, I'd consider joining FB just for that site. Just like on this site, it's really helpful to talk things over with other pet parents who are dealing with the same stuff you are.
 
Laura Nels said:
I have been hesitant to add to many more things to the mix as I already feel like I'm always coming at her with something: pricking her ear, injecting her, pilling her.
Click to expand...

You hum it, I'll play it.

I've managed to find ways to get Saoirse to take some of her meds in her food now and that helps a bit. I'm also mastering the art of drive-by pilling ...

.
 
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Hi

My cat has IBD and steroid use pushed him into being diabetic. Fortunately a change to a low carb novel protein diet allowed him to come off the steroids long enough to get him off the insulin.

Unfortunately the IBD reappeared and so eventfully he had to go back on the steroid. I have tried both the prednicare and budesonide and found that the budesonide actually controlled his IBD less and and increased his blood glucose more. So as the saying goes every cat is different.

My suggestions would be to slowly switch to a novel single source protein wet food. And consider try adding a probiotic. Make only one change at a time. This may allow you to reduce the steroid dose slightly.

With regards the Chlorambucil from my recent readings this is usually given alongside a steroid rather than instead. the current thinking is to give a pulsed dose of Chlorambucil , one tablet every two weeks with the dose based on the weight of the cat. This causes less side effects and is given alongside an anti nausea medication such as odansteron and cerenia. The anti nausea medication is given the day before, on the day of dosing and the day after the Chlorambucil.

You might like to join the small cell lymphoma yahoo group as they discuss this protocol and have the linked research articles. They are also really helpful

https://groups.yahoo.com/neo/groups/feline_SMALLCELL_LYMPHOMA/conversations/messages
 
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