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Cat Forum / Health and Behavior / February 2004Depo Medrol vs Prednisone
I need to make a choice about whether to continue Cheeks (4-year-old shelter rescue, female, spayed, and with beautiful intact little feets! ) on Depo shots or do prednisone pills for her asthma and linear granuloma (rodent ulcer) problem. One shot every two to three months keeps both under control. My vet tells me that is not a lot of Depo, so that she is not at a high risk for side effects. However, there are side effects with Depo including increased diabetes rates in cats so inclined and impaired liver and kidney function. He told me today that oral Prednisone is less likely to cause the liver and kidney problems than the Depo shots, but that otherwise it has the same risk of side effects as Depo shots. He also told me that oral Prednisone will be fine for her asthma but will not do as good a job controlling her linear granuloma. He added that since linear granuloma is not life threatening, perhaps that does not matter so much to me. However, those little bumps Cheeky gets on the back of her legs bother her, she scratches and bites there a lot. And, I really hate to see those little blackhead-like bumps on her beautiful little nose. Here are the questions: have any of you had cats who needed long-term steroids? Did any of them develop side effects from either quarterly Depo Medrol shots or long-term use of oral prednisone? If so, what happened? Any opinions on what I ought to do are welcome. I appreciate your input and thank you in advance. Feb 2004: > He told me today that oral Prednisone is less likely to cause the > liver and kidney problems than the Depo shots, but that otherwise it > has the same risk of side effects as Depo shots. Our vet said the exact opposite. Shamrock gets Depo shots for his allergies. Prednisone would be used more consistantly, while depo shots are given "as needed". FTR, Shamrock is so far doing OK with antihistamines. He gets a little spacey sometimes, but one spot actually cleared up on its own without steroids. Another flare-up *did* require a depo shot, but the vet was surprised about that one spot.  SignatureCheryl Trapped like rats. In a chia-pet. MIB II > Feb 2004: > [quoted text clipped - 8 lines] > cleared up on its own without steroids. Another flare-up *did* require a > depo shot, but the vet was surprised about that one spot. Cheryl--what sort of "spot?" Does Shamrock have linear granuloma too? I know it correlates with allergies. Does Shamrock have asthma, and if not, what are his allergies? Also, please tell me more about these antihistamines, nobody has offered that as an option. Thank you. Feb 2004: > Cheryl--what sort of "spot?" Does Shamrock have linear granuloma too? > I know it correlates with allergies. Does Shamrock have asthma, and if > not, what are his allergies? Also, please tell me more about these > antihistamines, nobody has offered that as an option. Thank you. Shamrock breaks out in lesions and this has been constant since before I even got him -- he had lesions when I was first asked to foster him. It was suspected that he had flea allergies but when a year went by of keeping him dosed with Advantage like clockwork (even off season), and he'd been examined by different vets MULTIPLE times combing him for fleas or flea dirt, had a skin scrape for mites, cultured for ringworm, and all the while had to have depo shots every 2-3 months (which he always responded to quickly), never a flea was found either on him, in my house or on the other cats. Finally his newest vet diagnosed EGC (eosinophilic granuloma complex) by elimination. I read up on this and found the following article which is why I asked about antihistamines: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2544 "Two groups of "alternative" therapies, most of which have been tried in small numbers of cases, only in prospective studies or have been empirically / anecdotally reported as effective, are available. The first group of "alternative" treatments includes antihistamines and essential fatty acids. These drugs have few reported potential side effects but also few possibilities to work in case of lack of therapeutic efficacy of glucocorticoids. " Another article stated that sometimes finding the right antihistamine can be trial and error, because while one may have no effect, another might be the right one. I asked the vet about Chlortrimeton (Chlorpheniramine) because of another article I read and she agreed it was worth a shot and gave me the dosage information for him. She said she'd had good results with dogs more than cats with this, but to go ahead and try it. He also is on EFA suppliments (from the vets office, but similar to DermCaps) based on the vin article and a few others who'd stated the same thing. SignatureCheryl Trapped like rats. In a chia-pet. MIB II > Shamrock breaks out in lesions and this has been constant since before I > even got him -- he had lesions when I was first asked to foster him. It was [quoted text clipped - 6 lines] > cats. Finally his newest vet diagnosed EGC (eosinophilic granuloma > complex) by elimination. This is Cheeky's diagnosis--it is just the linear kind because she gets it in a straight line on her back legs, I think? I read up on this and found the following article > which is why I asked about antihistamines: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2544 > "Two groups of "alternative" therapies, most of which have been tried in > small numbers of cases, only in prospective studies or have been > empirically / anecdotally reported as effective, are available. > > The first group of "alternative" treatments includes antihistamines and > essential fatty acids. Okay. >These drugs have few reported potential side effects > but also few possibilities to work in case of lack of therapeutic efficacy > of glucocorticoids. " I don't understand the above sentence. I'll go read the article tomorrow morning when I am fresh. Thanks very much. >From: "Mary" rosefan@email.com >>These drugs have few reported potential side effects >> but also few possibilities to work in case of lack of therapeutic [quoted text clipped - 3 lines] >I don't understand the above sentence. I'll go read the article >tomorrow morning when I am fresh. Thanks very much. Hi Mary, I don't know anything about the Depo but have done a bit of research into cortisone. Our Meesha has asthma but not the granuloma. Our vet has prescribed a natural plant based cortisone that works on a biochemical basis differently than prednisone and is supposed to be safer and without the same side effects. So far, it's been working great. We also changed Meesha's diet and that has helped along with an air cleaner on our furnace. Here is a little exerpt from some of the materials I have on the natural cortisone from the Pet Pharmacy: "Adrenal suppression "Notorious for their effect on the endocrine system by shutting down adrenals activity, synthetic forms of glucocorticoids will usually necessitate a "weaning" period when curtailing therapy to allow the adrenal gland to recover its normal metabolic function of hormone secretion. Natural phytochemical-based cortisone (in its biologically presentable "cortisol" form), does not completely suppress adrenal output, with 22 percent representing the highest level of inactivity ever encountered by this writer. That entails over eight years of study and trials. Pure, pharmaceutical grade sterols function and affect a different level of the system than those of the synthetic variety, working in the peripheral tissues and circulating in the blood. The mission here is to build serum and tissue levels of the steroids and keep them elevated constantly so the body can draw from those stores using the cortisol-binding globulin (or transcortin) which binds cortisol and the sex steroid binding 17 globulin. As a matter of note, the estrogen derivative "estradiol" as well as testosterone also use the 17 globulin binder." "Calcium depletion is another factor in long-term or elevated synthetic steroid use. This process of depletion can be a contributor to congestive heart failure and circulatory deficiencies. Liver enzyme elevation is another common response to long-term synthetic corticolteroid use. Elevated aspartate transaminase (SGOT) and alanine transaminase (SGPT) serve as markers for the onset of liver disease, toxic hepatitis, infectious mononucleosis, pancreatitis, hepatocellular disease and active cirrhosis. These conditions have all been seen with long-term or elevated doses of the synthetic steroids." "Natural, plant derived cortisol, as well as the other natural corticosteroids have no metabolic end point. It wasn't "added" to their makeup to enable them to last longer in the body. Consequently, the half life of these components is very short - under four hours of active availability. So the faster they are able to reach their protein receptors, the less chance there is for premature oxidation, which would render them useless. Amino acid transporters and an assortment of nutrient carriers (including cortisol), are used to facilitate quicker, more reliable delivery capability to designated receptors in offsetting digestive obstacles and the short half-life inherent in the sterols. Assimilation through bio-availability is crucial for utilization. Just as dispersion and total excretion are keys for successful and safe results." Also, Yngver has a cat with asthma and she is having success with Flovent and the Aerokat to administer it. Not sure if this would be helpful for the granuloma though. Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm > X-No-Archive: yes > >From: "Mary" rosefan@email.com [quoted text clipped - 13 lines] > differently than prednisone and is supposed to be safer and without the same > side effects. So far, it's been working great. A word to the wise: I'd take Lauren's fanatical au naturel cult chants and anti-mainstream vet medicine histrionics with a large grain of salt if I were you.... Very, very few, if any, of her au naturel cult wonder drugs and treatments are supported by controlled, clinical studies or published in mainstream, peer-reviewed veterinary medical journals or texts. Au naturel wonder drugs and treatments can be very dangerous because they delay or prevent owners from seeking *real* veterinary medical care when it will do the most good and have the greatest chance of success. Any type of alternative medicine has its place in the medical management of our cats -- the *last* place - if and when mainstream veterinary medicine has failed. >From: "Phil P" phil@maxshouse.com >> X-No-Archive: yes >> >From: "Mary" rosefan@email.com [quoted text clipped - 29 lines] >alternative medicine has its place in the medical management of our cats -- >the *last* place - if and when mainstream veterinary medicine has failed. Let's see, shall I believe what my vet says and what studies support, or what an internet vet wannabe loser says? Get a grip, Phil, you really are pathetic, LOL. I'm sure Mary (with the help of a "real professional vet", and not your lunatic rantings) can make up her own mind. "fanatical au naturel cult chants and anti-mainstream vet >medicine histrionics" I see you're off your medication again, Phil ;) Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm I in fact did a recent internet search and found almost exactly what Lauren posted. The difference was that the depo worked better when accompanied by EFAs and antihistamines, and ultimately the steroids were needed in lesser quantities and less often. > >From: "Phil P" phil@maxshouse.com > [quoted text clipped - 48 lines] > http://www.geocities.com/rawfeeders/ForCatsOnly.html > Declawing Info: http://www.wholecat.com/articles/claws.htm > I in fact did a recent internet search and found almost exactly what Lauren > posted. The difference was that the depo worked better when accompanied by > EFAs and antihistamines, and ultimately the steroids were needed in lesser > quantities and less often. Betsy, you are talking about treating asthma and not linear granuloma and its associated problems, right? Or both? > >From: "Phil P" phil@maxshouse.com > [quoted text clipped - 33 lines] > > Let's see, shall I believe After all your conjured up, conflicting bullsh!t stories, I don't think anybody really cares who or what you believe.... Face it, its more than obvious you're not exactly a credible source of reliable information... >what my vet says Is that the same vet who you said was a "nutritionist"....? But after being informed of the certification process required for veterinary nutritionists, you were forced to admit she wasn't a nutritionist... and that was just another one of your conjured up bullsh!t stories... You went from her being a "nutritionist" to "she had a lot of training in nutrition" --- from whom? LOL! You believe anyone who tells you what you want to hear and chants the same mindless mantra... then you try to impose your opinions on others by using scare tactics, rumors and innuendo... That's why you're just as, if not more ignorant now than you were when you began posting! > and what studies support, Oh yes, lets not forget your famous "studies"....How come you often post the "study" but rarely post the urls? You don't want people to know your "studies" really came from other au naturel cult fanatics' web sites and not from credible veterinary medical or peer-reviewed publications? I really liked your story about white blood cells attacking grains in the gut!!! LOL! That story was hilarious! Who told you that one? Your vet "nutritionist"? LOL! or what > an internet vet wannabe loser says? "internet vet wannabe", huh....? Funny you use that phrase... Most people in this group -- including you, buffoon, give advice just like I do, but you call me an "internet vet wannabe".... Why is that? Is it because you're envious and resent the *fact* that I have astronomically more experience and knowledge than you? Actually, *you're* the "internet vet wannabe" because that's where practically all your information comes from... you don't work with cats, you have no practical experience other than that of an average pet owner... you just parrot other peoples' information and situations... Get a grip, Phil, you really are pathetic, > LOL. I'm sure Mary (with the help of a "real professional vet", and not your > lunatic rantings) can make up her own mind. Then why did you post practically an entire web site, buffoon? > "fanatical au naturel cult chants and anti-mainstream vet > >medicine histrionics" > > I see you're off your medication again, Phil ;) You ought to know all about medications.... > Hi Mary, Hi! It took me a while to absorb the info in your post. I think I understand the article now. Tell me, how often do you give Meesha the plant-based cortisol? How long has she been on this? How often did she have attacks before? About the calcium deficiency side effect of Depo, I wonder if I could give Cheeks some supplements, maybe drops in her food? >From: "Mary" rosefan@email.com >> Hi Mary, > >Hi! It took me a while to absorb the info in your post. I think I >understand the article now. Tell me, how often do you give Meesha the >plant-based cortisol? How long has she been on this? How often did she >have attacks before? Hi Mary, Meesha was having several attacks a week. She never had any open mouth type attacks, but only coughing. We started her on the natural cortisol about 6 months ago. She gets a small dose every day for 10 days, then she doesn't get any for 3 weeks, then this cycle is repeated again. This medicine has proved to be very effective for Meesha so far. My vet says it is still a hydrocortisone but without some of the serious side effects that prednisone can have. As long as this keeps working, we will stay with it. But if it ever stops working, I think I would definitely entertain trying the Flovent and Aerokat that Yngver's cat is on. I think cats handle steroids better than humans do (my cousin had very serious side effects from steroids and ended up having some fingers and toes amputated after he almost died from pneumonia:( So for now, I'm very happy with the results from the natural cortisone. >About the calcium deficiency side effect of Depo, I wonder if I could >give Cheeks some supplements, maybe drops in her food? I would be leary about supplementing with just calcium. I understand when supplementing commercial foods which already have synthetic vitamins added in, you run the risk of causing a nutritional imbalance. For one, you would be getting the proper calcium/phosphorous ratio out of balance. So to that end, I would definitely speak to your vet in this regard. HTH, Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm > >From: "Mary" rosefan@email.com > [quoted text clipped - 3 lines] > Meesha was having several attacks a week. She never had any open mouth type > attacks, but only coughing. Poor thing. I assume you mean the hunched over, deep kind of spasmodic coughing that Cheeky does. She closes her eyes and the tip of her little tongue sticks out, and it is kind of slow motion, seems to take forever. Definitely not a little "cough cough" thing. We started her on the natural cortisol about 6 > months ago. She gets a small dose every day for 10 days, then she doesn't get > any for 3 weeks, then this cycle is repeated again. This medicine has proved to [quoted text clipped - 3 lines] > think I would definitely entertain trying the Flovent and Aerokat that Yngver's > cat is on. So you give it in pill form? The admininstering doesn't sound bad, and certainly would be less traumatic for her than loading her into the cat carrier and taking her to the vet. >> I would be leary about supplementing with just calcium. I understand when > supplementing commercial foods which already have synthetic vitamins added in, > you run the risk of causing a nutritional imbalance. For one, you would be [quoted text clipped - 3 lines] > HTH, > Lauren You are always helpful, Lauren, it is great having you and the others to draw upon for information and advice. About vitamins, I wonder if there are any liquid vitamins, like a multi-vitamin, the kind that comes with a dropper, I used to see them for babies, but for cats? Wouldn't it be great to put a couple of drops of goodness in the canned cat food? >From: "Mary" rosefan@email.com >> >From: "Mary" rosefan@email.com >> [quoted text clipped - 44 lines] >You are always helpful, Lauren, it is great having you and the others >to draw upon for information and advice. You're most welcome, Mary :) I know how heartbreaking it is watching a kitty have an asthma attack. If you and your vet decide you want to try the natural cortisone, I'd be more than happy to ask my vet for the pharmacy number. I know you asked in another post how we administer it but now I can't find that post. Anyway, at first we tried it in pill form but Meesha was hard to pill so we had it compounded into an olive oil base and we give it via eyedropper. It seems to be less stressful on Meesha doing it this way rather than the pills. Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm on 06 Feb 2004: > If you and your vet decide you want to try the natural > cortisone, I'd be more than happy to ask my vet for the pharmacy number. I am going to have to go back to some of the posts wrt this. Can't hurt to read more, but when I asked Shadow's vet about trying prednisolone instead of prednisone for his IBD she didn't think it was worth trying to switch. While prednisone doesn't help his diarrhea, it does help the vomiting. He rarely (almost never) vomits as long as I don't try to mess with the pred dose. At one point the vet wanted to try to wean him down to every other day, or try cutting his 5mg dose in half and give him 2.5mg 2x per day instead of the 1 5mg 1x per day to slowly wean him down to every other day and even that messed with his tummy. Thanks for the alternative steroid info, Lauren. SignatureCheryl Trapped like rats. In a chia-pet. MIB II >From: Cheryl jlhshadow@NOSPAMhotmail.com >on 06 Feb 2004: > [quoted text clipped - 11 lines] >and even that messed with his tummy. Thanks for the alternative steroid >info, Lauren. You're very welcome, Cheryl. I know how dedicated you are to helping Shadow. He's a very lucky kitty to have you :) Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecat.com/articles/claws.htm Feb 2004: >> "Two groups of "alternative" therapies, most of which have been > tried in [quoted text clipped - 6 lines] > > Okay. I took note of the vitamins Shamrock takes and they are EFAVites by Allerderm. I also forgot to mention that Shadow is on Prednisone daily (5mg) for his IBD for ~18 months, and while I've tried to lower the dose without success, his only real side effect from it *so far* is an increase in appetite. SignatureCheryl Trapped like rats. In a chia-pet. MIB II Mary wrote in news:70GTb.35738$YG.2749419@twister.southeast.rr.com on 03 Feb 2004: >> "Two groups of "alternative" therapies, most of which have been > tried in [quoted text clipped - 6 lines] > > Okay. I took note of the vitamins Shamrock takes and they are EFAVites by Allerderm. I also forgot to mention that Shadow is on Prednisone daily (5mg) for his IBD for ~18 months, and while I've tried to lower the dose without success, his only real side effect from it *so far* is an increase in appetite. -- Cheryl Can make them drink more too? circa Wed, 4 Feb 2004 07:53:06 -0500, in rec.pets.cats.health+behav, Wendy (wendypart@nospam.com) said, > I took note of the vitamins Shamrock takes and they are EFAVites by > Allerderm. I also forgot to mention that Shadow is on Prednisone daily [quoted text clipped - 6 lines] > > Can make them drink more too? Prednisone didn't make Alex drink more, but it definitely increased his appetite. Given that he had lymphoma, this was a very, very good thing. Laura SignatureI am Dyslexia of Borg, Your a.s will be laminated. >> Can make them drink more too? >> >Prednisone didn't make Alex drink more, but it definitely increased >his appetite. Given that he had lymphoma, this was a very, very good >thing. Our cat was on only a short course of prednisolone for asthma before we went to inhaled medications, but yes, it did make her drink and pee a lot more, plus eat more too. In her case, that was a bad thing because she was already overweight, and the extra poundage was exacerbating her asthma. That's why our vet did not want to put her on prednisone/prednisolone long term. So it can make them drink more as well as eat more, and perhaps sleep more too. There are a number of possible side effects of prednisone but not all cats experience all of them, or the worst of them. On the other hand, I subscribe to a mailing list for asthmatic cats and some have suffered serious health problems due to long term use of prednisone to try to contol the asthma. > >> Can make them drink more too? > >> [quoted text clipped - 13 lines] > a mailing list for asthmatic cats and some have suffered serious health > problems due to long term use of prednisone to try to contol the asthma. All good to know. I'm not eager to use the inhalers because I wonder what would happen if she has an attack when I'm not home. Or are they used regularly whether or not the cat has an attack, so that they prevent them? >All good to know. I'm not eager to use the inhalers because I wonder >what would happen if she has an attack when I'm not home. Or are they >used regularly whether or not the cat has an attack, so that they >prevent them? Yes, most cats with asthma will be given one or two puffs of Flovent either once or twice a day. It reduces or eliminates the inflammation in the lungs that results in the attacks. Some people also keep Albuterol (a bronchodilator) on hand for emergency attacks if the asthma is not well controlled. We have never used the Albuterol, but our cat only has mild asthma and her only symptom was frequent coughing. She never had trouble getting her breath. See http://home.triad.rr.com/alexisandjason/felineasthma/ for lots of info on feline asthma and various methods of treatment. This will explain the pros and cons of all the different kinds of medications we have been talking about here. The inhaled steroids work the same way the depo medrol and prednisone work to control asthma, except that it does not enter the bloodstream but goes straight to the lungs. > Yes, most cats with asthma will be given one or two puffs of Flovent either > once or twice a day. It reduces or eliminates the inflammation in the lungs > that results in the attacks. Some people also keep Albuterol (a bronchodilator) > on hand for emergency attacks if the asthma is not well controlled. This sounds like a lot to put Cheeks through for something that would only treat the asthma and not the granuloma problem. And there are times I am away and would not necessarily trust anyone to give her the treatment. She is hard to catch unless she wants to be caught, even for me. Albuterol is what I want to have on hand to give her immediate relief if she has an attack because I waited too long to get her a Depo shot, thanks for telling me. I do want to get that and an inhaler and have them on hand. > We have never used the Albuterol, but our cat only has mild asthma and her only > symptom was frequent coughing. She never had trouble getting her breath. I'm so glad hers is not too bad, and that this method is working for you. > See http://home.triad.rr.com/alexisandjason/felineasthma/ for lots of info on > feline asthma and various methods of treatment. This will explain the pros and [quoted text clipped - 3 lines] > control asthma, except that it does not enter the bloodstream but goes straight > to the lungs. Another good site to read! I'll get to it tonight. Thanks again. > I took note of the vitamins Shamrock takes and they are EFAVites by > Allerderm. I do understand the benefits of essential fatty acids. I wonder if I can get these online? Or, maybe my vet carries them. > I read up on this and found the following article > which is why I asked about antihistamines: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2544 Cheryl, forgive me if I take this one step at a time but the clinical language is difficult for me. In the first part of the article, if I get it, they are saying that both food and arthropod (bugs, fleas, roaches, any chitin-exoskeletoned creature) allergies have been linked to Feline Eosinophilic Skin Disease (let's call it FESD), and that there appears to be a hereditary component since many cats who are related get it. Before I go further, may I ask what foods, if any, they have isolated as possibly contributing to this problem? Thank you, I will read more tonight after work and try to read and digest all of the comments. This is important to me so I appreciate everyone's input and want to understand it fully. Feb 2004: > Cheryl, forgive me if I take this one step at a time but the clinical > language is > difficult for me. Same here. In the first part of the article, if I get it, they > are saying that > both food and arthropod (bugs, fleas, roaches, any [quoted text clipped - 4 lines] > Before I go further, may I ask what foods, if any, they have isolated > as possibly contributing to this problem? I haven't read anything like that. I've read a list of foods that are common allergens and they surprised me. The thing that stands out to me about EGC is that maybe it is mostly idiopathic in nature? That is the impression I got from the vet. Thank you, I will read more > tonight after work and try to read and digest all of the comments. > This is important to me so I appreciate everyone's input and want to > understand it fully. I hope you do, and if you do please share your thoughts. I haven't fully gotten it all yet, and with Shadow's problems, plus bringing in the feral Bonnie with all her issues and dealing with my own grief I am leaving it up to the vet other than asking her about what I have read because I'm just really worried about always using depo shots to give him relief. But I don't hesitate to call and ask if he can have another shot when it gets bad and I'm really glad it helps the poor lil guy. SignatureCheryl Trapped like rats. In a chia-pet. MIB II >> > Before I go further, may I ask what foods, if any, they have isolated > > as possibly contributing to this problem? > > I haven't read anything like that. I've read a list of foods that are > common allergens and they surprised me. Can you direct me to this list? >The thing that stands out to me > about EGC is that maybe it is mostly idiopathic in nature? That is the > impression I got from the vet. I had to look that up. :) It means arising on its own, and with no known cause, did I get that right? In other words it is not a result of some other condition? > I hope you do, and if you do please share your thoughts. I haven't fully > gotten it all yet, and with Shadow's problems, plus bringing in the feral [quoted text clipped - 3 lines] > don't hesitate to call and ask if he can have another shot when it gets bad > and I'm really glad it helps the poor lil guy. I'm still trying to get my little mind around it. So far, for the EGC it looks like the Depo shots, if kept to a minimum, are less likely to be harmful than the prednisone pills because the Depo causes less adrenal suppression. I think adrenal suppression is more likely to happen when does are given more frequently, which they are when given orally. Do I understand why adrenal suppression is a bad thing? Hell no! But I'm working on it. We have to keep it clear hear when we are talking about treatment for asthma and when we are talking about treatment for EGC. I'm talking EGC at the moment. But I have to add, it looks at this point like anyone with a cat with both asthma and EGC is better off with the Depo shots IF they control both with, say, a shot every two months or less. I'll keep trying to figure this out. Thanks for your help. > I'm still trying to get my little mind around it. So far, for the EGC > it looks like > the Depo shots, if kept to a minimum, are less likely to be harmful > than the > prednisone pills because the Depo causes less adrenal suppression. Well, hell, Phil just said I got it backwards. :( I told you I wasn't good at this stuff. Mary wrote in news:gsBTb.35568$F86.3178289@twister.southeast.rr.com on 02 Feb 2004: > He told me today that oral Prednisone is less likely to cause the > liver and kidney problems than the Depo shots, but that otherwise it > has the same risk of side effects as Depo shots. Our vet said the exact opposite. Shamrock gets Depo shots for his allergies. Prednisone would be used more consistantly, while depo shots are given "as needed". FTR, Shamrock is so far doing OK with antihistamines. He gets a little spacey sometimes, but one spot actually cleared up on its own without steroids. Another flare-up *did* require a depo shot, but the vet was surprised about that one spot. Do you know what Shamrock is allergic to? > Do you know what Shamrock is allergic to? No clue. Fleas were ruled out, it could be environmental (household allergies) but he was a stray before I got him and lived outdoors for some time before the caretaker took him to the HS. That certainly doesn't rule out allergens that come into the house from the outdoors but I haven't narrowed it down. I vaccum often and while I don't have a HEPA air cleaner, I have another type that is supposed to elliminate household allergens. It could also be food because I couldn't complete the food trial so I feed him canned food with as few grains as possible (that he will eat!). Tuna seemed to cause a flare-up a while back so I don't give him any food with fish. SignatureCheryl Trapped like rats. In a chia-pet. MIB II > I need to make a choice about whether to continue Cheeks (4-year-old > shelter rescue, female, spayed, and with beautiful intact little [quoted text clipped - 23 lines] > Depo Medrol shots or long-term use of oral prednisone? If so, what > happened? My kitty has been on depo medrol off and on for 13 years (eosinophilic granuloma complex) - no effects to date. -L. "-L." <k3_e81@yahoo.com> wrote in message > My kitty has been on depo medrol off and on for 13 years (eosinophilic > granuloma complex) - no effects to date. Ahh, gad, really? That is wonderful news. (I tell you, this skinny little gray tabby has stolen my heart.) Your kitty is not an asthmatic, just the granuloma? > "-L." <k3_e81@yahoo.com> wrote in message > > [quoted text clipped - 5 lines] > little gray tabby has stolen my heart.) Your kitty is not an > asthmatic, just the granuloma? Yes. She doesn't have EGC very bad - but has had it since 8 weeks old - probably was born with it. She breaks out about 1-2 times per year. Now that she's older, she has broken out more often. -L. > Yes. She doesn't have EGC very bad - but has had it since 8 weeks old > - probably was born with it. She breaks out about 1-2 times per > year. Now that she's older, she has broken out more often. > > -L. I hope she doesn't get worse in time. Congrats on the baby! > Here are the questions: have any of you had cats who needed long-term > steroids? Did any of them develop side effects from either quarterly > Depo Medrol shots or long-term use of oral prednisone? If so, what > happened? Not an easy question -- Cats usually require high dosages - higher than dogs, at least - to get the same effect, but they also seem to develop less adverse effects than dogs. Usually, but I can't say always - its better to give a cat larger doses less frequently than smaller doses more frequently - and taper the dose to the smallest amount that will produce the effect you want. Steroids have an effect on almost every cell in the body - some cells can handle the effects better than others - so to my mind, the least dose as possible that will prpduce the desired effect the better. I've had a few cats develop PD/PU (polydipsia/polyuria) from long-term prednisone therapy that resolved almost completely by switching to methylprednisolone (less mineralocorticoid effects than prednisone). A few also developed polyphagia (increased appetite) - nothing serious - I just had to adjust their feeding patterns - same kcal/day just smaller and more frequent meals - kept them satiated without feeling hungry all day. Most of them did fine on regular b.i.d. feeding without any changes. Your greatest fear is probably diabetes. Steroids, especially daily prednisone, causes glycogen to be converted back into glucose and then released back into the bloodstream. This isn't true diabetes and not that common with alternate day dosing and even much less common with monthly and even less common with alternate month depo and almost also resolves with discontinuance of steroid therapy. Most of the adverse effects you read about steroid therapy are caused by long term, every day dosing. Of course, as with any therapy, a careful assessment of the risk to benefit ratio must be made. In your cat's case, and in those of millions of other cats, the benefits of steroid therapy far outweigh the risks and have literally made the difference between a happy life and a miserable life as the difference between life and death for many cats. Best of luck. Phil > Not an easy question -- Cats usually require high dosages - higher than > dogs, at least - to get the same effect, but they also seem to develop less > adverse effects than dogs. Usually, but I can't say always - its better to > give a cat larger doses less frequently than smaller doses more frequently - > and taper the dose to the smallest amount that will produce the effect you > want. Phil, this means I should continue the shot. But can you tell me WHY it is better to give large doses less frequently? >Steroids have an effect on almost every cell in the body - some cells > can handle the effects better than others - so to my mind, the least dose as > possible that will prpduce the desired effect the better. This is why I wait at least three months between shots of Depo. Last shot was November, and she had not had one since July--four months. That was when the linear granuloma showed up, when I waited so long between shots. I take her in at first significant cough or when her purring becomes "thick" and she swallows a lot, which has to mean congestion. This usually happens between two and three months after a shot. The doctor tells me that this is fairly light use of Depo, for an asthmatic cat. > I've had a few cats develop PD/PU (polydipsia/polyuria) from long-term > prednisone therapy that resolved almost completely by switching to [quoted text clipped - 3 lines] > frequent meals - kept them satiated without feeling hungry all day. Most of > them did fine on regular b.i.d. feeding without any changes. I really do not want to mess with Cheeky's appetite. She is trim and fit, does not eat too much. Half a small can of food in the morning, sometimes half at night (she lets me know if she wants it) and free feeding dry, she goes through just half a small bowl in a day. She weighs in at 7 pounds usually, 7.5 when I push the wet food. The doctor says that is a good weight for this petite little girl. > Your greatest fear is probably diabetes. Steroids, especially daily > prednisone, causes glycogen to be converted back into glucose and then > released back into the bloodstream. So Phil, all this combined with the fact that prednisone will not control the linear granuloma well means that I need to keep her on Depo and NOT switch to prednisone. Isn't that what you are saying? This> > In your cat's case, > and in those of millions of other cats, the benefits of steroid therapy far > outweigh the risks and have literally made the difference between a happy > life and a miserable life as the difference between life and death for many > cats. Yes indeed. > Best of luck. Thanks so much, I get a lot out of your posts and can tell they are well thought out. > Phil, this means I should continue the shot. But can you tell me WHY > it is better to give large doses less frequently? Less HPA axis suppression. > I really do not want to mess with Cheeky's appetite. The > doctor says that is a good weight for this petite little girl. If she's doing fine, don't change anything. > This> > [quoted text clipped - 13 lines] > Thanks so much, I get a lot out of your posts and can tell they are > well thought out. Thanks. I wish I had more time to cover more details. Good luck. Phil > > Phil, this means I should continue the shot. But can you tell me WHY > > it is better to give large doses less frequently? > > Less HPA axis suppression. I looked this up and found out that it means: "hypothalamic-pituitary-adrenal" suppression. This is what my vet said happened less with the Depo (he just said "adrenal suppression") than with the prednisone, presumably because the prednisone would have to be given about every other day. > > > Phil, this means I should continue the shot. But can you tell me > WHY [quoted text clipped - 4 lines] > I looked this up and found out that it means: > "hypothalamic-pituitary-adrenal" suppression. That's correct. This is what my vet said > happened less with the Depo (he just said "adrenal suppression") than > with the prednisone, Your vet actually said that? :-/ Now you know why steroids are the most misused, overused and abused drugs in veterinary practices... with amoxicillin/clavulanic acid and baytril running a dead heat for second place... Kinda like the veterinary equivalent of "take two aspirins and call me in the morning" -- only instead of aspirins, its 'take two steroids and antibiotics......" Depo Medrol is a "repositol or "repository glucocorticoid" -- Basically, its intermediate acting methylprednisolone in an acetate base that produces a greater duration of therapy and a more sustained release over weeks (or months) -- as opposed to anywhere between 12-36 hours with prednisone. When steroid treatment is either long term (greater than a few weeks), or with high doses or with potent or *repository* injectable corticosteroids (e.g., Depo Medrol), the normal HPA is *chronically* inhibited. IOW, the greater or longer the anti-inflammatory capability of the steroid, the greater the capacity to suppress the HPA axis. Thus, the detrimental effects on the HPA are less with the short/intermediate acting *oral* prednisone (especially with alternate day or every third day dosing) and greatest with the long-acting repository injectables (e.g., Depo Medrol), Another very serious disadvantage of repository glucocorticoids is the drug can't be discontinued if the cat develops an adverse reaction or side effects -- Once its in the body you can't get rid of it rapidly - perhaps not fast enough -- presumably because the prednisone would have to > be given about every other day. Yes, that's absolutely right.... Prednisone would have to be given every other day or in some cases, better still, every third day... but there is *no* HPA axis suppression between doses. Think it over. Phil > > > > Phil, this means I should continue the shot. But can you tell me > > WHY [quoted text clipped - 12 lines] > > Your vet actually said that? :-/ Wait a second. YOU said this, in answer to my question: > > Phil, this means I should continue the shot. But can you tell me WHY > > it is better to give large doses less frequently? > > Less HPA axis suppression. See why I am confused? What am I missing? Are you saying that large doses of PREDNISONE cause less HPA (adrenal) suppression? > > > > > Phil, this means I should continue the shot. But can you tell > me [quoted text clipped - 16 lines] > > Wait a second. YOU said this, in answer to my question: I think you're a little confused ;) -- I said "Your vet actually said that?" --- because I was surprised your vet said less HPA suppression occurs with Depo Medrol than with prednisone, because I know that's not true. > > > Phil, this means I should continue the shot. But can you tell me > WHY > > > it is better to give large doses less frequently? > > > > Less HPA axis suppression. > See why I am confused? Not really. Seems pretty clear to me. You said: "But can you tell me WHY it is better to give large doses less frequently?" I said: "Less HPA axis suppression." You said: "This is what my vet said happened less with the Depo (he just said "adrenal suppression") than with the prednisone," I said: "Your vet actually said that?" --- meaning I was surprised your vet said less HPA suppression occurs with Depo Medrol than with prednisone, because I know that's not true. > What am I missing? Read my previous post over. Are you saying that large > doses > of PREDNISONE cause less HPA (adrenal) suppression? Larger doses of prednisone administered less frequently (e.g., e.o.d.) produce less HPA suppression than smaller doses administered more frequently (e.g., q.i.d.). For example, 10 mg prednisone administered every other day produces less HPA suppression than 5 mg administered every day. The rationale behind alternate and every third day dosing is to minimize HPA suppression. Let me put it another way that might be a littler easier to understand: Prednisone is active for between 12-36 hours. HPA function is suppressed during this time because when the blood contains a high level of cortisol the adrenal cortex shuts down its own production of glucocorticoids. When the adrenal cells that synthesize glucocorticoids shut down, they begin to atrophy. When the exogenous steroids are no longer active and/or blood cortisol levels returns to normal or low, the body's HPA function begins to return. Thus HPA function begins to return to normal between e.o.d. dosing intervals so that HPA suppression is minimal over the course of the drug therapy. Depo Medrol is a repository injectable corticosteroid that's not much stronger - its only about ~20% more potent than prednisone - but its formulated to produce a greater duration of therapy by a more sustained release over weeks or even months. During this time HPA is *chronically* inhibited whereas with oral e.o.d. prednisone therapy, HPA is inhibited *intermittingly* and the risk atrophy of the adrenal cells that synthesize glucocorticoids is minimal or nonexistent. I hope that clears it up for you because I don't think I can explain it any clearer than that... Good luck. Phil Thanks for taking the time to further explain, Phil. The problem was, I had a false dichotomy set up in my addled brain, so that Depo = large dose less frequently and Prednisone = small dose more frequently. The reason is that these are the only choices I have been offered by my vet. See below: > > > This is what my vet said > > > > happened less with the Depo (he just said "adrenal suppression") [quoted text clipped - 9 lines] > your vet said less HPA suppression occurs with Depo Medrol than with > prednisone, because I know that's not true. Follow? If the choices were just a Depo shot once every three months, or prednisone every other day, it *would* be true that Depo is the better choice for asthma, and it has to be the better choice for EGC because prednisone does not control EGC, just asthma. > Are you saying that large > > doses [quoted text clipped - 26 lines] > glucocorticoids is minimal or > nonexistent. Yes, this is very clear. However, it seems Depo Medrol shots are the best thing for my cat because she has BOTH asthma and EGC, and because I am only having the shots administered about every three months. I appreciate your input. > Yes, this is very clear. However, it seems Depo Medrol shots are the > best thing for my cat because she has BOTH asthma and EGC, Mary, glucocorticoids are rated by their strength compared to Hydrocortisone - which is rated at "1". Prednisone is rated at "4" and methylprednisolone and prednisolone are both rated a "5". Dexamethasone is rated at "30" and Betamethasone, at "25-40". Methylprednisolone which is the *same* active ingredient in Depo - is also available in pills - which would afford your cat the benefits of E.O.D. dosing without any reduction in efficacy. and because > I am only having the shots administered about every three months. Owner compliance is a major part of successful treatment. You didn't say whether or not your cat was difficult to pill. If she is, than perhaps 3-month depo injections are necessary. > I appreciate your input. Good luck. Phil "> Mary, glucocorticoids are rated by their strength compared to > Hydrocortisone - which is rated at "1". Prednisone is rated at "4" and > methylprednisolone and prednisolone are both rated a "5". Dexamethasone is [quoted text clipped - 3 lines] > available in pills - which would afford your cat the benefits of E.O.D. > dosing without any reduction in efficacy. Phil, this is wonderful information, I saved it in my cat file. Thanks for taking the time to explain this. It is hard for those of us with no training in this area to understand. All we know is what the vet tells us. > and because > > I am only having the shots administered about every three months. > > Owner compliance is a major part of successful treatment. You didn't say > whether or not your cat was difficult to pill. If she is, than perhaps > 3-month depo injections are necessary. She is not hard to pill, but she is really good at pretending to swallow then spitting it out when I leave. I found little half-dissolved prednisone pills all over the house after her last session. My cat Shadow sufferes from Inflammatory bowel disease. She has been on Prednisone for over 8 years now with no bad side effects. The only side effects I've seen are increased appetite on the Prednisone. She is now 16 and 1/2. Gail > I need to make a choice about whether to continue Cheeks (4-year-old > shelter rescue, female, spayed, and with beautiful intact little [quoted text clipped - 26 lines] > Any opinions on what I ought to do are welcome. I appreciate your > input and thank you in advance. > My cat Shadow sufferes from Inflammatory bowel disease. She has been on > Prednisone for over 8 years now with no bad side effects. The only side > effects I've seen are increased appetite on the Prednisone. She is now 16 > and 1/2. > Gail She has no asthma, then? >He also told me that oral Prednisone will be fine for her asthma but >will not do as good a job controlling her linear granuloma. He added [quoted text clipped - 11 lines] >Any opinions on what I ought to do are welcome. I appreciate your >input and thank you in advance. The treatment of choice for asthma is now becoming inhalable medication such as Flovent. Inhaled steroids go directly to the lungs and do not have the negative side effects of injectable or oral prednisone. It seems to me you might want to consider Flovent for the asthma and something else for the linear granuloma. That way you will avoid the serious risks associated with long-term use of oral prednisone. "Yngver" <yngver@aol.comnospam> wrote in message > The treatment of choice for asthma is now becoming inhalable medication such as > Flovent. Inhaled steroids go directly to the lungs and do not have the negative > side effects of injectable or oral prednisone. It seems to me you might want to > consider Flovent for the asthma and something else for the linear granuloma. > That way you will avoid the serious risks associated with long-term use of oral > prednisone. I am thinking about it, but it seems the Depo covers both, and since I don't use it more than about four times a year, my doctor says she is unlikely to develop side effects. Unless the dosage goes up, of course. >I need to make a choice about whether to continue Cheeks (4-year-old >shelter rescue, female, spayed, and with beautiful intact little [quoted text clipped - 26 lines] >Any opinions on what I ought to do are welcome. I appreciate your >input and thank you in advance. I have two cats with asthma and one with EGC. Trill, with EGC, was only diagnosed last year and has only had a few shots, but it certainly hasn't seemed to be a problem for him. Internet, with asthma, has been on 1/2 tablet Prednisolone every other day for about two years, with no noticeable problems or side effects to date. Sabra, with more severe asthma, has been on one tablet of Prednisone every third day (dosages have changed over time) for maybe 6-7 years? I have seen no obvious problems with him, either. He also gets Albuterol occasionally as well. Attacks have been rare in the past year since going to this dosage schedule with the Albuterol. I do worry about side effects, but so far, I have not seen any problems in my guys. Best of luck to you and your kitty! Ginger-lyn
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