New Member (Dx 2020) IBD and weaning off pred | Feline Diabetes Management Board

New Member (Dx 2020) IBD and weaning off pred

Hannah and Phoebe

Hannah and Phoebe

Member
Hello! My name is Hannah and my cat's name is Phoebe. She was diagnosed in 2020, and has been mostly "stable" throughout, but I've come to realize, not healthy. Or at least not as healthy as she could be. So I'm here seeking that quality of life for her. I'm so grateful this place exists!! Phoebe has GI issues and we are currently weaning her off of prednisolone to see if that will have a positive effect on her diabetes. (She was put on the pred a year or so AFTER the diabetes diagnosis to treat the IBD.) I've pasted my full information below, and her spreadsheet is up to date as of this morning. @Marje and Gracie have been helping me with her spreadsheet, and helped me transition to a 12/12 schedule this past weekend.

My main concerns right now are worrying myself sick about hypos, second guessing when to shoot and not to shoot based on PS (for example I shot this morning at 150 but I'm not sure if that was the right decision), and planning the transition to low-carb wet food. Looking at other's spreadsheets it seems she is on a relatively high dose of ProZinc, and that worries me as well. Just something I didn't realize before.

Anyway, I'm very glad to be here and despite all my worries, I am also very excited to begin improving Phoebe's health as much as humanly possible!

Me: Hannah
Kitty: Phoebe, 12yrs (born 2013), Female domestic longhair
Diagnosed: Spring 2020
Current Insulin: Prozinc
Current Meter: ReliOn Premier Compact (human)
Blood Testing: 4x/day during transitional periods, 4x/week during stable periods, Considering continuing to use the Freestyle Libre going forward
Complications from diabetes: polyuria, polydipsia, suspected early stage neuropathy

Other conditions:
  • (Former) Stomatitis, all teeth removed at ~1yr old
  • IBD/general GI issues, loose stools
  • Arthritis
Other medications:
  • Prednisolone (GI issues) (currently weaning off!)
  • Prozyme powder
  • B12 injections
  • Solensia (arthritis)
Current Diet: Open Farm Raw Mix Open Prairie Formula (Dry), 1/4 cup 2x/day (plan to switch to a wet food after steroid weaning is complete)

Other Kitties: Yuji (M, 9yrs), Jack (M, 8yrs) (both non-diabetic and no major health issues)
 
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Hello and welcome. First thing, any insulin dose that's making you see numbers under 50 is too high and should be reduced. Does she graze on dry or eat it at particular times of the day? Dry can make a huge difference in insulin needs.

If her GI issues persist after weaning prednisolone, you might want to consider budesonide. It's also a steroid but more locally acting and for some cats (like my Neko) did not impact blood sugars. Were her GI issues diagnosed as IBD with a biopsy or endoscopy?

Tagging @Suzanne and Darcy who has a lot more dosing experience than me with Prozinc.
 
Hi @Wendy&Neko! Thank you for the response! I would love to reduce her dose, but am not sure how to go about that. My vet actually recently suggested increasing it to 6.0 units. I think the prozinc forum has guidance on how to systematically reduce dosage, but I am still parsing through that and would really appreciate some guidance there.

We don't free-feed, but if we are home they all get a snack of their regular kibbles around lunchtime and at bedtime. Although recently she had been running really high at those times so I had been limiting that.

There was no clinical testing done to diagnose her IBD. She presented with frequent diarrhea and going outside the litterbox. The vet did some blood and fecal tests to rule other things out and landed on IBD eventually. And surmised that her diabetes could be a contributing factor.
 
Hannah and Phoebe said:
I would love to reduce her dose, but am not sure how to go about that.
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Just measure a smaller amount on the syringe. Do you have half unit marked syringes? I would NOT increase, especially as you are lowering the prednisolone dose. How much pred is she getting per day now? Down from her max dose of ? Reducing pred usually means reducing the insulin dose. I would reduce by either 0.5 or 0.25 units. Rate of pred reduction could influence how much you reduce.

I've had three cats in a row with small cell lymphoma, the other condition that can look like IBD on an ultrasound and have similar GI symptoms. Did she have ultrasound? Current kitty has IBD and small cell lymphoma, but has been in remission from SCL for several years now. Unfortunately IBD is still there and requires pred, though a smaller dose. As long as I stay away from the proteins that cause issues, she's fairly stable. Has Hannah had her diet changed since the GI disease?
 
I do not have half unit markings on the syringes but she is currently on 5.5, so it would fairly easy to go to 5.0 units. 5.25 would be harder to estimate but I could do it. I have calipers and lots of measuring experience (am an engineer).

She was on 2.5mg twice a day. On 7/29 we decreased to 2.5mg once a day (only mornings). On 8/9 we decreased to 2.5mg every other day, and plan to continue that until 8/18. She'll then get zero.

Phoebe has never had an ultrasound, no. Since her diabetes diagnosis we have changed her diet back and forth between Science Diet m/d and w/d a few times. She was on w/d most recently, and then on 3/27 of this year we transitioned all three cats to their current food, Open Farm Raw Mix Open Prairie Formula (Dry). I would like to explore new feeding options as well, but was going to wait until she is off the pred, just so I'm not throwing too many changes at her at once.
 
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