Prednisolone and diabetes

[Voula]

Hi everyone. I would like to learn of your experiences with using prednisolone for cats that have both IBD and diabetes or lymphoma and diabetes. Our internal medicine specialist and local vet would like to avoid prednisolone for my Lucy because of her diabetes but we may need to use it. We are also considering budesonide. Another medication being considered is cyclosporine but I am not keen on that after reading of possible side effects. My Lucy is currently on chlorambucil for IBD. Thank you.

 

[Maggies Mom Debby]

I'm not familiar with that specific combination of diseases, but remember, you need to treat the whole cat, not just the BG numbers. If you have to use the pred, you'll just have to compensate by adjusting your insulin dose. The goal is to keep Lucy as healthy AND as pain free as possible.

 

[Lillie]

I've had a cat with IBD and lymphoma who was on pred and chlorambucil but not diabetic and a current cat who has IBD and was diabetic but not on pred. I'm pretty sure someone here has or had one who is taking pred while being diabetic. I was told that if the pred is necessary to treat the IBD or lymphoma than the insulin needs to be adjusted around the condition. My current cat's specialist is also trying to not put my Leo on pred as he had a transient bout of diabetes and he does have IBD. I'm currently using metronidazole as needed for him but his IBD is mild. The Budesonide was recommended for him if his IBD worsens.

 

[Voula]

I'm not familiar with that specific combination of diseases, but remember, you need to treat the whole cat, not just the BG numbers. If you have to use the pred, you'll just have to compensate by adjusting your insulin dose. The goal is to keep Lucy as healthy AND as pain free as possible.

Thank you so much for your reply. I am reading about cats with IBD or lymphoma and diabetes who are on prednisolone and most seem to do okay except they might need higher insulin doses to treat the higher glucose levels caused by the prednisolone. The internal medicine specialist will prescribe it if nothing else works. I made an appointment with the local vet for tomorrow so she can give me her opinion also as I feel Lucy needs to be eating more at the moment. Thank you again.

 

[Voula]

I've had a cat with IBD and lymphoma who was on pred and chlorambucil but not diabetic and a current cat who has IBD and was diabetic but not on pred. I'm pretty sure someone here has or had one who is taking pred while being diabetic. I was told that if the pred is necessary to treat the IBD or lymphoma than the insulin needs to be adjusted around the condition. My current cat's specialist is also trying to not put my Leo on pred as he had a transient bout of diabetes and he does have IBD. I'm currently using metronidazole as needed for him but his IBD is mild. The Budesonide was recommended for him if his IBD worsens.

Thank you so much for your reply and for sharing your experiences with your kitties too. I think even a short course of prednisolone as a trial to see how Lucy does with it might be worth it at the moment as she continues to lose weight but then again her diabetes has been harder to regulate in recent months and I can see the logic of the internal medicine specialist to avoid prednisolone for now. Thank you again.

 

[Tracey&Jones (GA)]

Jones is IBD and became diabetic with the prednisolone. We did try budesonide but it didn't seem to work for him. Maybe if we started with that it would of been better. He was quite sever before we figured out the IBD - originally thought it was just pancreatitis.

He does better on the prednisolone and I keep working the juice to find his dose. He is currently on 5mg daily along with metronidazole 50 mg a day.

I have found the better the IBD is controlled, the easier it is to get him to eat. Which helps with keeping the BG's down and stimulates the natural digestion and insulin production.

Always a work on process however. I had a strategy that worked for 3 weeks then he stopped in the low carb food at night.

 

[vbc2000]

Tigger was on 5mg every other day and we were having no luck for months regulating. We cut back to 2.5 mg every other day and he achieved regulation about a month later. It definitely interfere with regulation. Tigger needs to be on it for allergies and the decreased dose seems to be holding them at bay. Perhaps a dose that low could work too. Tagging Jeff because I believe he is in the same situation as you. @JeffJ

 

[JeffJ]

Hi Voula - I responded on that other SCL forum. But I probably won't do any followups there. That SCL forum seems overly restrictive.

--> This thread <<-- summarizes Leo's current conditions and meds.

The prednisolone (pred) affects some cats differently. In Leo the persistent effects are:
- increase in BG (blood glucose), requiring a little more insulin
- increase in appetite
...and it is supposed to reduce internal swelling, but I can't see inside Leo!

There are pred side effects for some cats. To my knowledge Leo has not had any.

--> Missed Pred Dose <<-- this thread shows the effects of a missed dose.
On Aug 11, 2017 Theresa forgot his pred pill. The impact was lowered BG the next day, and almost a hypo.

Overall, I have found the prednisolone to be very effective for Leo. He had reduced appetite, but the pred helped with that. The compensation for elevated BG is easy to deal with. Lemme know if you have more questions.

 

[Wendy&Neko]

Neko had budesonide for her IBD/SCL because her heart condition meant she couldn't have pred. It did help reduce the bowel inflammation about 30%. Maybe not as good as pred would have done, but it didn't impact her blood glucose values. Tagging @Tricia Cinco(GA) & Harvey and @jayla-n-Drevon who also had to deal with steroids for gut issues and diabetes. We've had a number of members who had had to give pred for asthma. Same deal, just increase the dose to compensate.

 

[Tricia Cinco(GA) & Harvey]

Hi Voula.

My Harvey was put on Pred and Chlorambucil for his intestinal lymphoma. He became diabetic after a few months. The Pred increased his appetite, which was a bonus. At first we couldn't get him into regulation, but with some coaxing his IM agreed to try a reduced Pred dose and we got his FD regulated, to the point where I thought we were headed for OTJ! If you look at his SS, we reduced the Pred to 2.5 mg once a day on 4/15/16 and his insulin dose went down from there. His appetite became a little less enthusiastic, but we used Ondansetron, Cerenia and Cypro to manage that.

Between the Pred and the Chlorambucil, his lymphoma was stalled and did not worsen during the year or so he was on it. Unfortunately, we lost him to CKD.

If your kitties need Pred, so be it. You just adjust the insulin as needed, and see if the vet will work with you on finding the lowest possible dose of Pred that seems to be helping. Good luck!

 

[Voula]

Thank you so much everyone. I will reply to each of your messages tomorrow but I wanted to let you know I read them all and appreciate your messages very much.

 

[Larry and Kitties]

I would try the budesonide. I have had several cats on that, including two diabetic cats. It had little effect on insulin needs/BG.
If you go the prednesolone route, I would try to get your vet to prescribe a dose for every day dosing (vice every other days are discussed by a previous responder) since every other day dosing will make dosing/BG control difficult the prednesolone effects lasts about a day.

 

[jayla-n-Drevon]

my 2 cents... I also think budesonide is less "offensive" although it is still a steroid and my non diabetic became diabetic from it --I was able to get him in remission fairly quick as we all know the signs. Unfortunately he is back on budesonide but I am giving a lower dose and watching his numbers. I agree with Wendy--if it is really bad and they need it I too would give more insulin. good luck

 

[vbc2000]

Hi Voula - I responded on that other SCL forum. But I probably won't do any followups there. That SCL forum seems overly restrictive.

--> This thread <<-- summarizes Leo's current conditions and meds.

The prednisolone (pred) affects some cats differently. In Leo the persistent effects are:
- increase in BG (blood glucose), requiring a little more insulin
- increase in appetite
...and it is supposed to reduce internal swelling, but I can't see inside Leo!

There are pred side effects for some cats. To my knowledge Leo has not had any.

--> Missed Pred Dose <<-- this thread shows the effects of a missed dose.
On Aug 11, 2017 Theresa forgot his pred pill. The impact was lowered BG the next day, and almost a hypo.

Overall, I have found the prednisolone to be very effective for Leo. He had reduced appetite, but the pred helped with that. The compensation for elevated BG is easy to deal with. Lemme know if you have more questions.

Very cute pic!

 

[Amanda Weaver]

We are 3 days in on cyclosporine and so far so good. My girl happens to be allergic to everything and has grown a pretty nasty eosinophilic granuloma in her mouth. Regular steroids are more proven to help but the vet doesn't want to mess up her bg. Fingers crossed we stay side effect free