Relationship between steroids and diabetes?

Hi wonderful great people!

Would someone be so kind to explain to me the relationship between steroids and diabetes? My understanding is that the high dose of steroids my vet had Squeaky on may have been the cause of his diabetes. (He has pancreatitis and IBD.)

And my current vet (fired the old one), wants him completely off prednisilone. However, we still need to control the vomiting and diarrhea.

Could the diabetes be reversed by getting him completely off steroids?

Thanks a bunch.

Jan and Squeaky

 

Hi Jan, kitties with steroid-induced diabetes have a much higher than average chance of going into remission (becoming diet-controlled diabetics) once they are off the steroids.
However, pancreatitis is one of the conditions that can also make diabetes a bit harder to manage.

Steroids can increase blood glucose. There are several factors involved. They can cause the liver to release more of its own stored glucose. They can reduce the body's sensitivity to insulin. And they can also reduce the ability of the muscle and fat cells to absorb glucose from the blood. All of that, combined, can lead to diabetes.

Eliz

 

Max had chronic pancreatitis but not IBD so he was only treated with ondansetron, bupe, occasionally sub-q fluids, and cyproheptadine. He was tightly controlled but I think became diabetic from pancreatitis. It took two years at least for that to happen. Sometimes budesonide works in place of prednisolone and may be less likely to cause diabetes.

 

If Squeaky needs something for the IBD, you might want to talk to the vet about budesonide. It may be that something to aid in reducing inflammation would be helpful for both the IBD and pancreatitis.

@Wendy&Neko has experience with budesonide.

 

My girl was diagnosed with either severe IBD or small cell lymphoma. Her heart conditions (diagnosed at the same time) precluded proper diagnosis as she couldn't have anaesthesia. Her internal medicine vet opted for budesonide, also because her heart couldn't stand prednisolone. Since Neko's numbers were fairly well controlled at the time, I had a good view on what budesonide did to her numbers. After a couple days of higher numbers (she also started 4-5 additional meds at the same time), her numbers came back down to where they had been on her dose. I saw no impact on her blood sugars. An ultrasound a month later showed her bowel inflammation was down 35%, so budesonde was doing what it needed without impacting her diabetes. I've seen a number of kitties here make the switch from pred to budesonide with good results on the diabeties. @Kyle & Simon just celebrated remission lately because of it. We do get the odd kitty that sees a blood sugar impact on budesonide, but it's lower than than that of prednisolone.

 

Done. I sent an email to my vet. I am hopeful! Thank you so much.

 

Thank you for your detailed message. I hope this will be the ticket! I've contacted the vet about this. Let us keep fingers crossed.

 

My cat Buddy has terrible chronic pancreatitis, right now he is taking prednisone. I have been trying to get someone to put him on prednisolone with no luck. At this time I have been force feeding him for about 5 or 6 weeks, since he started the pred he is eating his dry food. Buddy, had prednisolone induced diabetes, but he only took the pred for a couple of days and that was almost 4 years ago. If I had a vet that was willing to give the prednisolone, I think I would stay with him. Buddy's pancreatitis is bad news and will make the cat and their owner miserable especially when they are diabetic and must eat. But I guess you gotta pick your battles.

 

Teresa is right, if pred is needed to manage a critical condition, give it and manage the diabetes around it, typically with a higher insulin dose.

 

Good luck @Jan D ! Simon has been doing great on budesonide! I am still testing his BG now and then JIC but so far so good. It has really managed his IBD symptoms well. Hoping it does the same for your baby!

 

Hey there

I have some experience with diabetic cats with both IBD and pancreatitis, so here is what I've learned:

Cerenia can have an anti-inflammatory effect on the pancreas and sometimes it can be enough on its own without any steroids to control pancreatitis; if Squeaky isn't on cerenia already, it may be worth a try!

Budesonide is an intestinal-specific steroid that comes with fewer systemic side effects, but it pretty much ONLY works for intestinal inflammation... so it won't help pancreatitis usually... and some cats will still have some blood glucose fluctuations from it, but their fluctuations should be lower than they were while on prednisolone.

I currently have one diet-controlled diabetic who IS on prednisolone long-term for stomatitis, pancreatitis, and IBD. She developed the diabetes when she was on 10mg daily and eating dry food. Dropping her to 7.5mg daily and changing her to canned food only controlled her blood glucose enough that she has never needed insulin. That was over 2 years ago; now her prednisolone dose is down to 5mg.

 

Wow THH, what a great story. And good information. I appreciate the opportunity to learn. Nice to hear of your kitty's improvement.

 

Thank you Kyle! Here's hoping we have good results on it for the Squeak. Hey what is JIC?

 

Sending hugs!

 

Thanks Elizabeth! So much to learn!!!!!

 

JIC...Just In Case?

 

My cat Bo has cholangitis and is on steroids. At the moment our plan is to be on a low carb diet and try to wean her off steroids and then see how her diabetes is going. If that doesn't help then she'll get insulin. So far diet change alone hasn't had any effect and it's a bit nerve wracking having an uncontrolled diabetic at home.

 

Oh sorry- JIC = just in case! I will keep my fingers crossed for Squeak!

 

Hi. Given that your cat has IBD and pancreatitis, it is worth giving it a try. As someone noted, the Budesonide targets the intestine-primarily upper so if the issue is lower, it will not work as well—and it will not do much for the inflammation outside of the intestine. However, if the IBD is actually causing/leading to the pancreas being inflamed, Budesonide may be work really well for both .
I hope this is the case because that would be great! Best

 

That’s it!

 

Wow, well it sounds like it is worth a try. The IBD is mostly diarrhea at this point so sounds like lower. However, who knows. Worth a try...... Prednisilone isn't the best..... Thanks for your thoughts.

 

It is definitely worth a try! Some Budesonide, probiotic and experiment with diet. Even if it does not work & it’s a more moderate case that requires Prednisolone—-it isn’t as bad as you may think. My cat has been on Prednisolone for over 5 years now and was diagnosed with DM just a little over a year ago now. He is doing amazing with both his chronic pancreatitis and his DM. At the end of the day, you have to manage the IBD and pancreatitis for them to be able to have a good quality of life.

 

Very cute kitty, but this kitty needs insulin, this is serious.