Prednisolone's effect/Miralax/Flovent/Pepsid dosing?

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Smokey

Smokey

Member Since 2010
Hi everyone!

Would you be able to tell me if you know how Prednisolone will effect my Smokey's Diabetes? Smokey has Hyper-T, Diabetes and Asthma.

Recently, his asthma has gotten worse and we have tried everything possible to avoid steroids. He is having an attack every other day and we have tried an antihistamine which I believe didn't work. He has also become very constipated since having 4 teeth extracted and switching to all wet food 3 weeks ago. We have tried all different brands of wet food all the way from the best down to fancy feast and his appetite is diminishing. He only eats about 1.5oz of a can every 12 hours therefore loosing weight. He is weak, depressed, hyper-sensitive to touch, doesn't wash himself and he won't eat his pill pockets anymore therefore, we are having to use the pill popper (not fun)!

I took him back to the vet today for another full blood panel (last one was 1 month ago) and (again) all of his blood work comes back perfect on paper. My vet doesn't want Smokey to have steroids anymore than I do and has been fully on board with my protocol with his lantus however, he now feels that something more is wrong with Smokey that the blood work isn't showing. Possibly cancer; I can't remember what he called the condition but it started with Paraneo.... syndrome.

He stated that if I'm comfortable with it, that we can try Prednisolone. He feels that all of these symptoms may improve with using this. Right now, we just don't have any other answers.

I would appreciate any given feedback regarding how this will effect his diabetes!
 
Re: Prednisolone's effect on BG

i don't know, but did want to suggest miralax or pumpkin for the constipation. both add fiber that should help him out.

hope you get some answers - it sounds worrisome. hugs!
 
Re: Prednisolone's effect on BG

I hope you can find some answers to help out w/poor Smokey. What a goregous kitty.

I'm wondering if a combination of known problems that Smokey is experiencing are creating a kitty that doesn't want to eat. Unregulated asthma, change in diet to wet, constipation and now so little food on board due to the inappetance that would contribute to fatigue.

Regarding the asthma....Curry has asthma and is on Flovent 440mg twice a day. I could tell her asthma was a little more active this last month due to all the pollen in the air.....but the flovent keeps her from the coughing and takes 3-4 weeks to get into the lungs. Her blood glucose increases slightly during the allergy months and now its beginning to go back down as the pollen begins to diminish. I'm not sure what y'all are treating Smokey with.... Has the vet thought about using the Flovent for the asthma?...of course, that is if you aren't using it already.....Some of the asthma kitties need to get on the prednisone first until they transition to the flovent aerokat mask/treatment. I believe the pred does increase the glucose. If you are interested in more information on the flovent please PM me.

Regarding the inappetance....Wondering if an appetite stimulant - Remeron- might help with the eating issue...not sure if it would interfere w/any other health issues that Smokey has though.

Constipation.....I've used the miralax with Curry.....initially everyday and now every other day...of course Smokey has to be eating to get the miralax.


Hugs...paws crossed that Smokey starts feeling better.
 
Re: Prednisolone's effect on BG

When Tucker started Prednisolone I thought his insulin needs would go up but they actually went down. I assume less pressure from the brain tumor equaled less pain hence the lower BGs. Every cat is different but for us, using the Prednisolone and having a comfortable happy cat was more important than possibly shooting more insulin.

Tucker's IBD did get better as a nice side effect of the Prednisolone.
 
Re: Prednisolone's effect on BG

Tarragon has asthma and diabetes. His diabetes is steroid induced from the asthma shots. We now treat him with the flovent inhaler as well, just like Tena and Curry. Tarragon is on 440mg twice a day. Before we started the flovent, the vet discussed just continuing the shots with Tarragon on an as needed basis since he already had diabetes. He said that we would have to increase the insulin dose for a week or two after each shot to counteract the higher BGs that the shot causes. We never did this and just went with the inhaler instead. We couldn't stand the thought of giving him a shot knowing his body doesn't do well with them.
 
Re: Prednisolone's effect on BG

Hard to tell. Tom went back on insulin when we started Pred. but he also started to eat dry food again at the same time in an attempt to get him to eat.

As the dry food novelty started to wear off and we removed it again, his insulin needs have started to come back down.

ECID
 
Re: Prednisolone's effect on BG

Zoe is another of the LL kitties with Diabetes and Asthma....she was also HyperT (she had the I131 treatment). Zoe is on Flovent for her asthma and does quite well, with no effects on her blood sugars. If you haven't tried flovent and have questions, please feel free to PM me too. Flovent is an inhaled steroid so you don't have the damaging side-effects of long term prednisolone usage. She gets 2 puffs in the am and 2 puffs in the pm......VERY easy to do.
 
Re: Prednisolone's effect on BG

I should add that Tucker was much older when he started Prednisolone and his brain tumor caused him to keep walking in circles. He didn't have a lot of time left, being sick for so many years before I adopted him. I forget that not everyone knows his back story and why he needed it.

He was 18 when he started the pred. If you can find a better alternative like the ones that have been offered, that would be fantastic. Just for Tucker, at his advanced age, being FD since adoption at the age of 13 and probably longer than that and his brain tumor, for us pred was the way to go and he lived very comfortably on it until he passed.
 
Re: Prednisolone's effect on BG

I am an advocate of the Flovent inhaler and know of many cats that do well with it. Prednisone is known to cause feline diabetes and quite often makes regulation more difficult necessitating an increase in insulin. I would use an appetite stimulant and a 1/4 of a 10mg pepcid ac twice a day since it helped my Thor tremendously and he is currently OTJ. I use a tsp of pumpkin/day for constipation in my dogs but would not in my diabetic cat since it can increase the bg too. To help flush the kidneys and help with constipation, I add 1 tbsp+ water to 1.5oz FF regularly (and if left in dish and dries I will add a little more to it). This has worked well for Thor and others in addition to 6-8 drops from a 1000mg Salmon oil gelcap that I mix in his last feeding (3oz FF w/ 2tbsp water) to cover his late evening snack and get cover him through the night. You could divide it in feedings any way you like. It is a little smelly but Thor loves the flavor! There has been many studies linking insulin resistance to high cholesterol. Not sure that there's anything to it but covered my bases with Thor and he did even better after I added it.
 
Re: Prednisolone's effect on BG

Norton was on Prednisolone for his brain tumor. I carefully monitored his blood sugar and we did not need to increase his dose. If anything, his need for insulin reduced a little. He was a moderately high dose acrocat -- getting about 15u PZI per day on a TID sliding scale. He reduced to about 11u per day split into 3 doses using his custom sliding scale.
 
Re: Prednisolone's effect on BG

Your vet may be thinking that the inappetance/anorexia is symptomatic of paraneoplastic syndrome. I wonder if there's an internal med specialist in your area that you could take Smokey to if your vet is stumped.

There are any number of cats here that have been on steroids for asthma or for IBD. Insulin needs can be worked around a steroid if BG levels rise. FWIW, steroids often have a positive effect on appetite.
 
Re: Prednisolone's effect on BG

Do Lou gets pred off and on for allergies and it really does not seem to effect his BG's but like others have said ECID
 
Re: Prednisolone's effect on BG

Thank you for all of the feedback everyone! How do you all use the Flovent and do you base the dosage on weight? I can't get near him during his attacks...do you use it as a preventative or use it during attacks? Also, is the Pepsid also given according to weight? Is this for the throwing up?

I remember the vet stating that the Prednisolone would be a pill (I believe once a day) but I can't even get him to eat a pill pocket right now because he is so backed up/uninterested in food. Do you know if the gel form for the ear works any differently than the pill form? I've never heard of that before.

Poor Smokey got an enema yesterday at 10:00am and it has now been 24 hours and still no poop. My vet said that the past few times he has been there, he completely freaks out during blood draws and it was horrible during his enema. It is SO tramatic for Smokey to go to the vet these days that he's been having asthma attacks in the car (5 minute drive) and there at the vet's office, even for routine exams. I have had him for 13 years and I have NEVER EVER seen him even hiss once. He said Smokey made noises and hissed/growled like he has only seen few cats do. He was so stressed out when I brought him home all night that his blood spiked up to 420! I haven't seen numbers like that since last July! He now associates the car ride and vet's office with pain.

I believe he is so backed up that when he does eat something now, he just throws it up and when he did try to poop prior to the enema, he would throw up while inside the litter box.

I will go up to CVS now and get some fiber that I can sprinkle on his food and see if he turns his nose up to that too!

I'm loosing my mind over here!! Ahhhhhh!!
 
Re: Prednisolone's effect on BG

Also for the Miralax, what dosage should I use for that?
 
Re: Prednisolone's effect on BG

oh poor smokey! my gosh you've got a lot going on.

i don't have experience with any of this, but wanted to suggest you edit the subject line of your first post so that the people who do have experience will see your question. it really makes a difference in getting help.

sending healing thoughts to your little one today. :YMHUG:
 
Thanks Julie and Punkin! I just wish I could take away all of his problems! I don't have any children, so he has been my whole world for so long now! Does a kitty need the Flovent if already taking Prednisolone? I don't want to order the Aero Kat if we start the steroid's next week.

Thanks again!
 
I would not add fiber until you have a better idea of what's going on. Miralax is dosed at 1/8 to 1/4 of a teaspoon twice a day. Please try to get Smokey to drink as much as possible with the Miralax as it draws water into the colon.

Pepsid AC dosing is 1/4 of a 10mg tablet twice a day.
 
HI!

Being that Smokey's asthma seems very out of control right now, it would probably be a good idea to start him on prednisolone, until you get an Aerokat and Flovent and Albuterol. Once he has been on the Flovent for 2 weeks, then you can start tapering the prednisolone down until he is managed on Flovent alone. Pepcid should always be given about 20-30 minutes before prednisolone to help protect from any digestive upset or ulcers. I think the dose for the Pepcid is 1/4 of a 10mg tablet....make sure it is not Pepcid AC Max or Pepcid Complete.....you want Pepcid AC or generic Famotidine 10mg

Flovent dosing since it is inhaled is not based on weight......it is based on severity of asthma symptoms. Zoe was on 1 puff twice a day of 220 Flovent....she satrted having symptoms (coughing, congestion) and I increased her dose to 2 puffs twice a day of the 220 Flovent and she has been and remains symptom free.

Albuterol inhalers are used as a rescue medication during a coughing attack. The albuterol opens up the airways. You can also use Albuterol before giving a flovent puff in there is congestion present.

Albuterol is more for emergencies, while Flovent is for longterm control of Asthma symptoms.

Here is where a lot of people order Flovent from: Flovent/Flixotide It is significantly cheaper to order from here instead of buying locally which can cost about $200 for 1 inhaler. I have been ordering from here for over 2 years without a single problem.

Miralx is usually dosed at 1/8 - 1/4 tsp upto twice per day. Zoe was constipated 2 weeks ago and our vet had us give her 1/4 tsp twice in one day....and it worked the next morning!

If you have any more questions....please don't hesitate to ask!
 
Re: Prednisolone's effect on BG

Smokey said:
I remember the vet stating that the Prednisolone would be a pill (I believe once a day) but I can't even get him to eat a pill pocket right now because he is so backed up/uninterested in food. Do you know if the gel form for the ear works any differently than the pill form? I've never heard of that before.!
Click to expand...

I gave pred via injection toward the end. This came from wedgewood pharmacy:
http://www.wedgewoodpetrx.com/items/prednisolone-injection-suspension.html

They also have transdermal (among other options):
http://www.wedgewoodpetrx.com/items/prednisolone-twist-a-dose-transdermal-gel.html

I got pepcid for injection through Sam's club (cheaper than vet). My guess is any of the medications you need could also be compounded by wedgwood in a form that works best for you guys.
 
Just stopping in to say Hello, Smokey...you handsome devil!
it's good to see you!

can't help with the questions...others have covered that, but want you to know that we're sending concentrated healing vines and prayers
for you...

celi & binks
 
you've already received good advice from those who are have experience dealing with asthma and steroids.
like sandy, i'm also wondering if the vet took x-rays while you were there to look for any blockages. please do not give fiber (stick with miralax) unless you know there's nothing blocking him. fiber could make things worse if there's any blockage. did the vet give you any sub-q fluids to administer at home? sometimes administering fluids can help with constipation.
 
No, we didn't take any x-rays, I'll have to ask him about that! He could feel the back-up inside smokey and just did the enema and said that I should have lots of poop a few hours later...now we are on hour 31 hours since and no pee or poop (but he is stubborn). His usual bowel movement is every 2-3 days and he only pees once a day (he's always been like that). I wonder since he gave them such a horrible time during the enema if it didn't work!? I think they needed to get him back in his cage quickly since he was having a nervous breakdown! He still seems very irritable right now and I've just been feeding him like 30 licks every hour today so he doesn't throw it all up again.

They will have to sedate him for any future appointments...his fear is that bad now! Never used to be.

My poor boy is just sleeping all day and when I get him up, he tucks his tail in-between his legs. He must be so sore! :cry:
(I gave him 1/8 of the miralax)

I'll look into the Wedgewood Pharmacy right now!
 
Can you place 2 different transdermal medications on at once (1 on one ear and 1 on the other ear)?
 
My vet gave us Pred. In liquid form that I just squirt in Tom's mouth. I did not want to try pilling because of the mass on his tongue.
 
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