My diabetic cat also has kidney disease and either IBD or lymphoma. He is poorly regulated despite intensive attention to the problem. He is on Cerenia, Zofran, and cyproheptadine. Clearly he is a hospice case, but he still seems to be enjoying life most of the time. The vet wants to start him on pred--recognizing the dangers, but having nothing else to offer. Has anyone been in a similar situation? If so, what was your experience? thank you.
Pred for diabetic cat?
- Thread starter bgenick
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Deb & Wink
Member Since 2013
Increase the insulin when needed to deal with the required steroid use.
Treating multiple medical issues is sometimes choosing the lesser of two evils.
Treating multiple medical issues is sometimes choosing the lesser of two evils.
Yes, my girl had diabetes and CKD when she was diagnosed with either IBD or small cell lymphoma. She couldn't get a proper diagnosis, which requires anesthesia, because she also had a heart condition diagnosed at the same time. When it rains, it pours. 
Anyway, she could not have prednisolone due to her heart condition, so she was put on budesonide instead. Budesonide is a more locally acting steroid, acting on the GI system. As a bonus for us, it did not impact her blood sugars. Prednisolone (not prednisone) will impact blood sugars, but if it's needed, we just raise the insulin dose to compensate.
I wouldn't call your cat a hospice situation unless the kidney disease is very advanced. If you can find out if it's either IBD or lymphome, those can be treated. Although they have different treatments, so it's good to know what you are dealing with. With the proper chemo protocol, cats can go into remission from small cell lymphoma, often for years. The chemo for small cell is fairly mild drugs, one of which is the steroid.
Anyway, she could not have prednisolone due to her heart condition, so she was put on budesonide instead. Budesonide is a more locally acting steroid, acting on the GI system. As a bonus for us, it did not impact her blood sugars. Prednisolone (not prednisone) will impact blood sugars, but if it's needed, we just raise the insulin dose to compensate.I wouldn't call your cat a hospice situation unless the kidney disease is very advanced. If you can find out if it's either IBD or lymphome, those can be treated. Although they have different treatments, so it's good to know what you are dealing with. With the proper chemo protocol, cats can go into remission from small cell lymphoma, often for years. The chemo for small cell is fairly mild drugs, one of which is the steroid.
Tomlin
Member Since 2019
Hi. My T is taking Prednisolone and as others have stated, you just adjust the insulin as needed. Keep in mind that Inflammation will cause an increase in BG, so not treating an underlying issue can actually be more of a detriment to the diabetes than a drug like Pred. You can always try the Budesonide first. While it has a reputation of being less systemic than Pred, it depends on the cat and their GI situation. Even with cats with no lymphoma, it can still raise BG, but it may not. The Pred has been a life saver for my guy and without it he becomes very sick and miserable. We just adjust the Pred dose up and down as needed & for some cats you may even be able to get away with every other day dosing. I’ve actually had to increase the insulin with smaller doses of Pred and lower it with higher doses. Again, the inflammation from an underlying disease, if not treated, will often raise blood glucose so best to get it under control 
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Deb & Wink
Member Since 2013
The swings in BG like that are not because of the pred. They are the likely result of the dose.
We need context to understand the variations in those BG levels. SS would do that for us, and you.
Getting a spreadsheet (SS) linked to your signature can be a big help. There is a template, simply make your own copy. Detailed directions on how to do the setup include using a pc, tablet, smartphone.
FDMB Spreadsheet Instructions
Understanding the Spreadsheet/Grid
We need context to understand the variations in those BG levels. SS would do that for us, and you.
Getting a spreadsheet (SS) linked to your signature can be a big help. There is a template, simply make your own copy. Detailed directions on how to do the setup include using a pc, tablet, smartphone.
FDMB Spreadsheet Instructions
Understanding the Spreadsheet/Grid
Tomlin
Member Since 2019
We started with Vetsulin and it was sudden drops which was especially concerning for our T with pancreas and GI issues. We switched to Lantus at the advice of a specialist from Cornell & it has worked well. Every cat is going to be different with the meds. For my specific cat, the Pred increases his BG for about 3 hours. The increases have actually decreased with time with the Lantus on board. We give the Pred at night because our guy drops lower at night so we take advantage of that and also give a slightly higher dose of Lantus PM vs AM. It has worked out. With that being said, if you are able to try Budesonide and it makes sense as per your specialist given your cats diagnosis, I would try it. If it doesn’t work well or it’s not an option, then you can move on to Pred if it’s necessary.
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