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Old 07-22-2009, 06:59 PM
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Default Re: Autoimmune disorder in cats - advice needed!

Quote:
Originally Posted by lynielime View Post
well thing is, my vet is also reluctant to prescribe anymore steroids and antibiotics. she doesn't think they will be good for coco. that's why now i'm looking into alternative holistic methods.. she has improved a little already so now we want to maintain this. but how?
Being a autoimmune person myself, I'd say, steroid is very, very, very important to control an autoimmune disorder. It works to get symptoms under control. Once symptoms has subsided or improved, steroid dosage will be tapered slowly.

Autoimmune can adversely affect kidney, liver, lungs in a very short period of time, so the long term side-effects of steroids are not the primary concern!
Steroid is a very potent and life-saving drug, although like many drug, is not without side-effects.

BTW, is your vet certain of Coco's autoimmune diagnosis?

I've read that "cats" are pretty resistant to side-effects of steroids (aka preds...), pls check out the link below, I've also copied and paste the text for your easy reading!

http://www.vetinfo.com/ceffect.html

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Long term use of cortisones

Question: Dear Dr. Mike,

Two years ago, I wrote to you regarding our cat, Equus. We adopted he and his brother from a no-kill shelter at 11 weeks. They were healthy (except for a tendancy to be overweight) but did have some problems with their teeth (our vet called it 'sheltermouth' -- teeth not developing properly in stray kittens due to lack of nutrients).

At 4 years of age, our vet decided to pull teeth. Equus had all of his back teeth pulled. Over the next 4 months, he lost 7lbs. The vet was flummoxed. Then, he began to vomit profusely. Two days later, I woke up in the middle of the night to find him curled on my legs -- burning hot. He was weak and lethargic. I took his temperature and it was 106!! I panicked and called the vet. I ended up on the phone with the vet for 30 minutes while I held Equus, wrapped in freezing cold, wet towels.

For two months, Equus faded away. We tried everything, to no avail. Finally, our vet thought he found Hemobartenella in his blood smears and we started treating. He sent the blood to the U. of Colorado for testing. It came back negative. At our wits end and fairly sure we were going to lose our beloved boy, we agreed to let them do exploratory surgery. They took stomach lining sample and finally were able to diagnose Equus with Inflammatory Bowel Disease (although it was a difficult case to diagnose, even after staring at Equus' insides.)

Equus is doing well now -- though, he still has bouts of vomiting from time to time. We are fairly a well-oiled machine in dealing with it. A week of prednisone and he is back to normal. And here is my only question: long-term prednisone? Can we expect Equus to live a long life (barring any other health-problems)? Or, does long-term low-dose predinisone usually affect the liver too extensively?
Anyway. I thought I would let you know how helpful you were during this panicked and seeminly hopeless time. And, if it helps, here are Equus' symptoms and our treatment machine, just in case anyone out there is dealing with something similar. There is hope!

Weight Loss Depression Vomitting -- regurgitation, in our case. Constipation, sometimes with blood (irritation related) High Fever (only happened once)

*Equus eats probably 7 times a day, we feed him whenever he shows interest. He eats pretty well. We have him on Limited Diets Canned Rabbit. He will instantly regurgitate anything else.

*We are very careful not to leave any other food out that he can get into. Once in awhile, he gets into things anyway (this cat is a genius and a junkfood addict). This last flair-up was brought on by a piece of barbecue chicken wing he got out of the very bottom of the trash.

*We bought a water-fountain style cat water dish with a filter in it. He has had less frequent flair-ups, though he still does have them about every 3 months.

*We keep their box immaculately clean. This also seems to help for some reason.

*During a flair-up, he gets half a 5mg prednisone two times a day for 5 days, and then one time a day for 5 days. He also gets a quarter tab of tagamet in the morning.

Anyway, again -- thank you, so much. I cannot tell you how distraught we were when I last wrote. We have a happy home again.

Always Fondly, Stephanie

Answer: Stephanie-

I am glad that Equus' problems are under control. You have worked hard to make that happen and Equus is fortunate that you choose to adopt him.

Cats are pretty resistant to the side effects normally associated with prednisone usage in humans and dogs but can develop clinical signs of hyperadrenocorticism, such as hairloss, increased drinking and urinating, pendulous appearing abdomen, with continuous use of corticosteroids over a long time span. This usually happens when using long acting injectable corticosteroids at frequent intervals, though. Dogs are much more prone to developing "iatrogenic", or medically induced hyperadrenocorticism, due to cortisone administration.

Liver problems associated with cortisones are also not reported as often in cats as often as they are in dogs and liver problems severe enough to be life threatening are rare even in dogs. There are elevations in serum alkaline phosphatase (SAP) associated with the use of cortisones. Since this enzyme is also elevated in liver disease, there is the mistaken impression that the cortisones cause liver damage frequently. There is a similar impression that kidney damage may be occurring due to increased drinking and urinating. Both impressions are false. Actual liver damage from corticosteroids does happen but it does not happen frequently.

To sum this up, cats are pretty resistant to the side effects of cortisones. If you can successfully use oral prednisone to control the inflammatory bowel disease and you can use it in a "pulse" treatment manner, as you describe, it is very unlikely that Equus will suffer long term problems from the corticosteroid. Even long term use of prednisone on an every other day basis (NOT daily) in cats is unlikely to cause clinical signs of hyperadrenocorticism or liver damage. There is an increased tendency to develop diabetes with long term alternate day use of prednisone in cats, though. So try to stick with the occasional therapy (pulse therapy) approach that you are currently employing for as long as possible.
You have a good relationship with your vets, so I am sure that they will keep you informed of any changes that worry them, such as hairloss or a more pendulous look to Equus' abdomen, and you should do the same.

Mike Richards, DVM 4/28/2000

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In short, if it is really autoimmune, I personally think that steroid is the way to control ...

{{{{hugs}}}}} to Coco, what a character gal!
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