Steroids, long lasting injectable or oral?

[Lisa and Angel]

Hi all,

Angel's sister Mittens needs to go on a steroid for IBD/SCL. She's got some risk factors for developing diabetes (genetics since she's Angel's blood sister, overweight most of her life, prone to stress hypers, on HC dry food) and I'd like to know which is the safer option, long lasting injectable or oral prednisolone? I wanted to try budesonide initially, but she's got some signs pointing towards it being SCL including massive muscle and weight loss, so I think we need a harder hitting option than that unfortunately. I'm not sure which long lasting injectable the vet would give (whether it's just pred or depo or dexa or something else), but she said this'd be her first go to. Angel developed diabetes from such a shot, so I'm hesitant. But if it's just as safe as oral (regular prednisolone starting high and tapering down), then I'd rather follow my vet's advice.

If it matters at all, vet saw most of the inflammation in her stomach and first part of the small intestines on ultrasound. Biopsies were inconclusive but all else has been tried and failed.

 

[Lara & Luciole (Lu)]

Sounds like my Luciole's diagnosis. She started with oral pred, then we tapered her dosage down, and then switched her to budesonide, and gradually lowered the dosage to once every 3 day. She was already diabetic.

I know it's different for every cat, but this was a lifesaver for Lu. She has to be at least 16 years old, and is youthful, vigorous, all her weight back, glossy fur, and running up and down the stairs and bossing the boycats around. She'll be on budesonide for the rest of her life, and likely actively diabetic as well, but her quality of life is pretty fab.

I am hoping for the same for Mittens. I personally feel safer with oral meds than long-acting injections, because if there's any negative reaction it's easier to deal with. In Lu's case, we were watching her closely every day after starting on the pred, to see how she was reacting.

 

[Wendy&Neko]

My Neko went on budesonide for her suspected SCL. Her heart condition wouldn't permit either a biopsy, or prednisolone. It did reduce her GI inflammation.

To answer the question long lasting or more frequent dosage, I would go with the more frequent one. Much easier to stop if a problem arises (such as heart issue). Also easier to change the dose. Not all frequently dosed prednisolone forms are oral. Methyl prednisolone is also an option and I've read about injectable forms of it.

My two other SCL cats were on pred, one started on a higher dose then lowered, the other started on a smaller dose, then tapered down.