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Re: Appetite stimulants, useful experience

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  • psychoforkaatz
    I can completely understand your struggle. And I realize that sometimes you have to make choices, which is of course why I did not say not to use these meds
    Message 1 of 21 , May 2, 2008
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      I can completely understand your struggle. And I realize that
      sometimes you have to make choices, which is of course why I did not
      say not to use these meds but to weigh the risks and benefits which
      obviously you have to do on a daily basis. I empathize with you
      having to watch Snowball go thru all this.

      Just a note, Josie has IBD and possibly even pancreatitis and the
      rest except the CRF which turned out to be infections from kidney
      stones. I kept thinking that there was an underlying infection going
      on and I was right. We put her on a month of Zenequin (antibiotic)and
      her appetite issues and diarreah and spitting up, kidney and liver
      numbers (Oh yeah, cholangiohepatitis too)normalized. After being off
      it for two months, her kidney numbers went up again so back on the
      zenequin due to kidney infection, afterwards due to blood in the
      urine we found out she had stones via xray. We are going to pulse her
      on and off the antibiotics every few months as it seems infection is
      actually what is causing most of her problems, including what we
      thought at first were clot related heart attack and three strokes
      which I now believe were a pancreatic attack and hepatic
      encephalopathy (she went aggressive and mental like a stroke but due
      to infection reaching her brain). So for anyone who has just gone by
      what their vets told them and it was more guesswork than proof (like
      I did), trust your instincts. If I hadnt my cat would not be alive
      right now but I kept telling my vet I suspected infection and amoxi
      for two weeks just didnt cut it. She is a different cat after the
      longterm AB's.

      Kendall and Josie (who now has lost her appetite due to the aspirin I
      think!)



      --- In feline-heart@yahoogroups.com, "Carol" <carolroars@...> wrote:
      >
      > I struggle with this all the time with Snowball who besides HCM
      also
      > has IBD, chronic pancreatitis, hyperthyroid and CRF. Snowball is
      so
      > nauseated all the time, really - 24 hours a day - that she just
      won't
      > ever eat on her own without the drugs... which I hate.
      >
      > We tried Cyproheptadine, and it worked so-so for the eating, but
      she
      > was still nauseated and throwing up all the time. And, yes, it did
      > raise her heart rate and respiration.
      >
      > In March we started using the Mirtazapine, which is also an anti-
      > nausea med in addition to being an appetite stimulant. The
      > Cyproheptadine is only a stimulant. We call it Meow-tazapine,
      because
      > Snowball gets very meowy and "happy" the first day on it. I cut
      the
      > tablets down into teeny tiny 1/16th pieces...the dose the vet gave
      us
      > was 1/4 of a 15mg tablet, but after reading through the
      pancreatitis
      > and CRF groups' archives, most people get by with the 1/16 to 1/8
      of a
      > tablet, so that's what we gave Snowball.
      >
      > The Mirtazapine we give every 72 hours, and the first day she feels
      > really pretty okay, will eat well and acts like her old self
      without
      > any nausea to speak of...but the next two days aren't as good and
      > sometimes getting through those next two days is like she didn't
      even
      > get the Mirtazapine. Sometimes it only works for one day and the
      rest
      > of the time till the next dose, she feels crummy.
      >
      > The Mirtazapine also raises her heart rate and respiration. Her
      > sleeping/resting heart rate is 160 to 200 and her respiration is 28
      to
      > 32...and that's when she's asleep! So that part of it does worry
      me,
      > but seriously...without the Mirtazapine she just won't eat at all
      and
      > her nausea and vomiting wipe her out.
      >
      > We've tried slippery elm bark for Snowball, actually still give it
      to
      > her every night to get her through the wee hours of the mornings
      when
      > her tummy seems to be the worst, but by itself, it didn't do the
      trick
      > for her.
      >
      > We also do give her the Pepcid (sigh)... and that raises the heart
      > rate too... so we're slowly trying to wean her off of it, reducing
      her
      > dose slowly over the course of however long it takes to get down to
      > nothing, to see if she can be without that one at least.
      >
      > While I'm not usually one to advocate drugs, because I do like to
      try
      > to treat things holistically, sometimes there just isn't a benign
      way
      > to deal with the symptoms...and I say that again, "treat the
      > symptoms", because that's all we're doing. We're not "healing"
      > or "curing" anything, only covering up a symptom of what's really
      > going on, and that part of it bothers me too...because I know that
      > even though Snowball may "feel better" on the Mirtazapine, I know
      it's
      > not doing anything to "cure" her IBD or pancreatitis, which are the
      > biggest concerns for her right now. But on the other hand, I can't
      > let her feel so bad all the time just because I don't like using
      the
      > drugs...so I weigh one against the other all the time and choose to
      > give her the Mirtazapine and hope every day that it's not
      destroying
      > her heart too much.
      >
      > It's definitely a serious sitation with heart kitties, giving them
      > appetite stimulants and things like Pepcid. I'm always in the back
      of
      > my mind, worrying what it's doing to her heart.
      >
      > If I could get Snowball to not be nauseated all the time and get
      her
      > to eat without the stimulants, I would rather have it that way.
      >
      > hugs,
      > Carol and Snowball and the gang
      >
      >
      >
      >
      > --- In feline-heart@yahoogroups.com, "psychoforkaatz"
      > <psychoforkaatz@> wrote:
      >
      > HOWEVER, you must seriously weigh the risks of giving any of these
      > stimulants to a heart kitty as they are not recommended. They are
      > stimulants and can raise the heart rate as well as a host of other
      > side effects. Even Pepcid which many doctors suggest for upset
      tummy
      > is not recommended for heart kitties. I am going by the information
      > that comes as inserts with the drugs, and regarding the appetite
      > stimulants, various vets who say they should not be given.
      >
    • rzivorad
      As I told, I use mirtazapine at the dosage of 0.4mg/kg body weight (exactly 0.37mg/kg which equals 0.17mg/lb). It is really small dosage and I don t see any
      Message 2 of 21 , May 3, 2008
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        As I told, I use mirtazapine at the dosage of 0.4mg/kg body weight
        (exactly 0.37mg/kg which equals 0.17mg/lb). It is really small dosage
        and I don't see any change except slight agitation, though I must
        admit that I didn't control my cat's heart rate after administration
        of mirtazapine. She has dilated cardiomyopathy, but she also acquired
        hepatic disease, lost appetite and that all finished with hepatic
        lipidosis. She recovered from it, but still there are moments when she
        refuses to eat. What else can I (or anyone) do, but to use appetite
        stimulant?

        Is Pepcid necessary? It cures peptic ulcers and similar disorders
        caused by histamine reaction in one's stomach. Maybe she doesn't need
        it at all. Why don't you try sodium bicarbonate instead of Pepcid.
        Joseph W. Bartges from The University of Tennessee, Knoxville, in his
        presentation at the 2003 WSAVA congress, advocated its use in CRF
        patients (cats, of course) for addressing metabolic acidosis. It's
        also good for stomach acidosis and, as far as I know, doesn't have
        side effects. I used it for that purpose in my deceased cat with CRF,
        and I was satisfied. And I think that weaning off the famotidine
        (Pepcid) is not necessary, it can be discontinued immediately (I used
        ranitidine, it is the medication of the same class, for my own
        stomach, they didn't mention weaning off it. I also searched the web
        for famotidine, no one word about weaning).

        Best wishes from Deda
      • C. Halligan
        Although my heart kitty does not have IBD thank god, I do have a kitty with IBD. She was given cyproheptadine to stimulate her appetite and an antacid.
        Message 3 of 21 , May 3, 2008
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          Although my heart kitty does not have IBD thank god, I do have a kitty with IBD. She was given cyproheptadine to stimulate her appetite and an antacid. Neither worked for her and she her IBD got worse. She was on prednisone for a while and I recently weened her off because I do not like what it will do to her long term. She gets bi-weekly homeopathic injections with 5mg of dexamethasone (another steroid, similar to prednisone) and this seems to be working (cross your fingers).
          I certainly hope my heart kitty does not develop this nasty disease. There was talk in this forum of an IBD group. Can someone provide me with the link so I can talk with others about IBD/IBS? Thanks and I hope your kitties are doing well.

          Cindy
          ----- Original Message -----
          From: psychoforkaatz
          To: feline-heart@yahoogroups.com
          Sent: Friday, May 02, 2008 6:11 AM
          Subject: [FH] Re: Appetite stimulants, useful experience


          Cyproheptadine is the name of the appetite stimulant I referred to in
          my last email. This drug was prescribed to my heart kitty
          (misdiagnosed as asthma, heart issues were unknown at the time), it
          was prescribed in an extreme overdose and nearly killed my kitty. I
          think it did damage to her heart that led to her subsequent death.

          That being said, many people I know on other lists, such as kidney
          and IBD, do use appetite stimulants with great success, including
          cypro. HOWEVER, you must seriously weigh the risks of giving any of
          these stimulants to a heart kitty as they are not recommended. They
          are stimulants and can raise the heart rate as well as a host of
          other side effects. Even Pepcid which many doctors suggest for upset
          tummy is not recommended for heart kitties. I am going by the
          information that comes as inserts with the drugs, and regarding the
          appetite stimulants, various vets who say they should not be given.

          My Josie is going thru loss of appetite issues right now, I think due
          to aspirin. She also has IBD and other multiple issues so appetite is
          a frequent problem. I use Slippery Elm Bark syrup which soothes the
          tummy (it is not an appetite stimulant but helps make the tummy not
          upset which can increase appetite), and I just keep trying foods and
          assist feed her to jump start her appetite again. Anything I can to
          get her eating. I found out that most of the time she loses her
          appetite it is due to an underlying infection and after a course of
          antibiotics she regains her appetite. Some AB's do upset the tummy
          too, we have had good luck with Zeniquin, not such good luck with
          amoxicillin or clavamox.

          I hope this helps. Anyone who has a heart kitty that uses appetite
          stimulants please feel free to weigh in here.

          Good luck,
          Kendall and Josie

          --- In feline-heart@yahoogroups.com, "rzivorad" <rzivorad@...> wrote:
          >
          > Hi again, Andrea!
          >
          > I also send this mail as public, supposing that somebody else has
          > problem with his/her cat's poor appetite.
          >
          > I have forgotten appetite stimulant in my previous male. It is well
          > known to me how great problem presents feeding the cat who doesn't
          > want to eat. I use Remeron (it is antidepressant, its generic name
          is
          > mirtazapine), the dose is 0.4mg/kg of body weight. Problem with
          > Remeron is that it comes in pretty large tablets (15mg, 30mg and so
          > on), so it is hard to divide it into small pieces of 1.5-2mg for an
          > average cat. Ask some pharmacist if he/she can prepare dosages for
          > your cat (it is so-called compounding pharmacy). Remeron is given
          only
          > twice a week, because it remains long time in cat's body.
          > Other medication which you can try is easier to apply, because it
          > comes in 4mg tablets. Total dose for a cat is 1mg, so it must be
          > divided in quarters. It's generic name is cyproheptadine (Americans
          > know it under brand name Periactin), it is antihistamine and is
          given,
          > usually, once daily, but it may happen that your cat has to have it
          > only once in few days, that is individual. If you notice that 1mg
          > dosage is too high (cat is very agitated), you should lessen it
          until
          > you find proper dose for your cat.
          >
          > Keep in mind that both medications cause agitation in cats, but
          don't
          > worry about it, you just have to establish the dose which your cat
          > tolerates best, while appetite is still increased.
          >
          > Best wishes from Deda
          >





          [Non-text portions of this message have been removed]
        • Carol
          hi Cindy, Here s a link to one IBD group I found. http://pets.groups.yahoo.com/group/FelineIBD/ Carol and Snowball and the gang ... wrote: There was talk in
          Message 4 of 21 , May 3, 2008
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            hi Cindy,

            Here's a link to one IBD group I found.
            http://pets.groups.yahoo.com/group/FelineIBD/


            Carol and Snowball and the gang


            --- In feline-heart@yahoogroups.com, "C. Halligan" <challigan2@...>
            wrote:
            There was talk in this forum of an IBD group. Can someone provide me
            with the link so I can talk with others about IBD/IBS? Thanks and I
            hope your kitties are doing well.
            >
            > Cindy
          • rzivorad
            Hi Cindy! I am little experienced in IBD, my cat was ill with it 5 years ago. It s nice to be the member of some forum, but there are both knowledgeable and
            Message 5 of 21 , May 4, 2008
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              Hi Cindy!

              I am little experienced in IBD, my cat was ill with it 5 years ago.
              It's nice to be the member of some forum, but there are both
              knowledgeable and also not so knowledgeable people there. If you want to
              learn of something, then learn from an expert. Here is a link to an
              article written by expert, it will help you much about IBD:

              http://maxshouse.com/inflammatory_bowel_disease.htm

              I think you were wrong when you stopped administering corticosteroids,
              you'll see why when you read this article.

              I am sorry, I know this message has nothing in common with heart
              diseases, but I see that cats of many people here , besides heart
              problems, also have problems with IBD. This article is worth reading!

              Many regards, Deda
            • C. Halligan
              Hi Deda, Thank you for the article. I read it and unfortunately I have read similar findings/statements before. I am wary about using terms such as expert
              Message 6 of 21 , May 4, 2008
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                Hi Deda,

                Thank you for the article. I read it and unfortunately I have read similar findings/statements before. I am wary about using terms such as 'expert' because of the perspectives these people tend to hold. Many allopathics are ignorant of homeopathic methods. Supportive methods were not mentioned such as including probiotics after antibiotic use.

                The ontology of veterinary medicine conflicts with non-allopathic methods and it doesn't help that pharmaceutical companies provide the capitalistic framework for educating future veterinarians and the maintenance of the vet system.

                Anyway, do I think that I was wrong to stop Chloe's steroid? I did it properly, ie. weening her off of it. For now, I am trying periodic injections of dexamethasone including homeopathic means. Do they work against each other? Theoretically yes but if I do not administer both the long term affects of the steroid use may occur more quickly.

                Thank you again Deda for the article. I think it succinctly articulates this nasty disease.

                Cindy
                ----- Original Message -----
                From: rzivorad
                To: feline-heart@yahoogroups.com
                Sent: Sunday, May 04, 2008 8:11 AM
                Subject: [FH] Re: Appetite stimulants, useful experience


                Hi Cindy!

                I am little experienced in IBD, my cat was ill with it 5 years ago.
                It's nice to be the member of some forum, but there are both
                knowledgeable and also not so knowledgeable people there. If you want to
                learn of something, then learn from an expert. Here is a link to an
                article written by expert, it will help you much about IBD:

                http://maxshouse.com/inflammatory_bowel_disease.htm

                I think you were wrong when you stopped administering corticosteroids,
                you'll see why when you read this article.

                I am sorry, I know this message has nothing in common with heart
                diseases, but I see that cats of many people here , besides heart
                problems, also have problems with IBD. This article is worth reading!

                Many regards, Deda





                [Non-text portions of this message have been removed]
              • rzivorad
                Hi Cindy! I use the term expert to indicate person who is the most knowledgeable in some area. No doubt that Mr Douglas Bronstad deserves that. The therapy
                Message 7 of 21 , May 5, 2008
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                  Hi Cindy!

                  I use the term expert to indicate person who is the most knowledgeable
                  in some area. No doubt that Mr Douglas Bronstad deserves that. The
                  therapy which is described in the article cured my cat from IBD!
                  Homeopathic methods didn't work, dietary changes failed completely.
                  Generally, you are quite right about pharmaceutical companies. You share
                  opinion with my son (or vice versa), who avers that pharmaceutical
                  companies don't want to discover medications which will really cure most
                  of known diseases (instead of just keeping us alive), because then they
                  can't sell us these (unduly expensive) medications.

                  I think that, in the case of IBD, probiotics supplement wasn't mentioned
                  deliberately, because in IBD gut flora (consisting of bacteria, of
                  course) usually overgrows, and my attack liver and pancreas through
                  common bile duct. The goal is to suppress it, not to recover it. In most
                  cases of cholangiohepatitis, there is concurrent IBD present.

                  When I told you that it was wrong to discontinue corticosteroids, it
                  wasn't because I thought you did it too fast. It was because you said
                  that you had done it fearing of adverse effects. That's not good reason,
                  because when the therapy is discontinued too early, recurrence can take
                  place. Besides, corticosteroids like prednisone/prednisolone don't have
                  serious adverse effects on cats. I have experience with long-term use of
                  prednisone in my cat and I really didn't notice any adverse effect (it
                  could be increased appetite, maybe, but she is so poor eater that even
                  long-term use of prednisone doesn't help). Many experienced vets, which
                  articles on corticosteroid therapy I read, assert the same.

                  All in all, I appreciate your message and I enjoyed reading it! Thank
                  you.

                  Many regards from Deda



                  [Non-text portions of this message have been removed]
                • katy4282003
                  actually you are wrong to say that long term use of steroids dont have serious adverse effects of cats. steroids lower immunity thus making the cat unable to
                  Message 8 of 21 , May 5, 2008
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                    actually you are wrong to say that long term use of steroids dont
                    have serious adverse effects of cats. steroids lower immunity thus
                    making the cat unable to fight infection just like in people. the
                    risk for diabeties and ulcers are also increased. steroids can
                    exacerbate heart disease. many experienced vets also give yearly
                    vaccinations but we know that isnt safe for our pets. i am glad to
                    hear that your cat hasnt had adverse reactions to steroids but that
                    is not always the case and steroids should be used with caution in my
                    opinion.
                    >^..^<
                    katy & belle



                    > When I told you that it was wrong to discontinue corticosteroids, it
                    > wasn't because I thought you did it too fast. It was because you
                    said
                    > that you had done it fearing of adverse effects. That's not good
                    reason,
                    > because when the therapy is discontinued too early, recurrence can
                    take
                    > place. Besides, corticosteroids like prednisone/prednisolone don't
                    have
                    > serious adverse effects on cats. I have experience with long-term
                    use of
                    > prednisone in my cat and I really didn't notice any adverse effect
                    (it
                    > could be increased appetite, maybe, but she is so poor eater that
                    even
                    > long-term use of prednisone doesn't help). Many experienced vets,
                    which
                    > articles on corticosteroid therapy I read, assert the same.
                    >
                    > All in all, I appreciate your message and I enjoyed reading it!
                    Thank
                    > you.
                    >
                    > Many regards from Deda
                    >
                    >
                    >
                    > [Non-text portions of this message have been removed]
                    >
                  • toomany_kittys
                    Hi Deda, Besides, corticosteroids like prednisone/prednisolone don t have ... of ... which ... I have to strongly dispute the statement above as I have a much
                    Message 9 of 21 , May 5, 2008
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                      Hi Deda,

                      Besides, corticosteroids like prednisone/prednisolone don't have
                      > serious adverse effects on cats. I have experience with long-term use
                      of
                      > prednisone in my cat and I really didn't notice any adverse effect (it
                      > could be increased appetite, maybe, but she is so poor eater that even
                      > long-term use of prednisone doesn't help). Many experienced vets,
                      which
                      > articles on corticosteroid therapy I read, assert the same.


                      I have to strongly dispute the statement above as I have a much
                      different experience with my kitty Jasmin and prednisolone.
                      Jasmin, 3 yrs old now, has a neurological condition called
                      demylineating neuropathy. It is an auto-immune disease that came
                      immediately after the FeLV vax and anaesthesia/spay done at the same
                      time with a previous caregiver. This was diagnosed by a neurologist.
                      The symptoms are severe ataxia, eventual limb paralysis, twitching,
                      thin coat, etc.. Of course her people then returned her to a shelter.
                      The only allopathic treatment is prednisolone. The neurologist put her
                      on a six mth treatment course of it. She is still on it after one year.
                      He told me of side effects. She has them. Her bladder walls have
                      thickened (common side effect), debris in her urine. It also is very
                      hard on the heart and her heart is checked periodically. She is being
                      weaned off of it but damage has been done by prolonged prednisolone
                      therapy. It did however, relieve the symptoms for the most part until
                      recently.
                      Now she goes to an integrative vet, along with the neurologist and we
                      will be trying alternative methods and supplements.
                      I truly wish that I'd never agreed to her being put on the prednisolone
                      for a prolonged period of time.
                      I'm glad the pred worked for your little one with no side effects. My
                      experience with it is the opposite.
                      El
                    • psychoforkaatz
                      The use of steroids for IBD cats is really a cat by cat decision. I have been a member of the IBD group for about a year although since Josie was also
                      Message 10 of 21 , May 6, 2008
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                        The use of steroids for IBD cats is really a cat by cat decision. I
                        have been a member of the IBD group for about a year although since
                        Josie was also diagnosed with heart disease I havent been there much. I
                        am glad that I personally chose to steer away from the use of regular
                        steroids as they would be detrimental to Josies heart condition, they
                        promote fluid retention and Josie has been having serious problems with
                        that lately. I use supplements and food changes and most recently a
                        long course of antibiotics to help with a recurring underlying
                        infection and Josie's IBD is much better. She was not a regular vomiter
                        but had constant diarreah. I think the food changes helped her the
                        most. So while many people have no choice after trying everything else,
                        to use steroids, each case is different and I think the fewer meds we
                        can get by using the better. I already spend 24/7 administering meds,
                        supplements and feedings to Josie, its a good thing I have no life.....

                        Kendall and Josie
                      • shannon5@charter.net
                        Hi Deda, I have been a member of this list for almost 6 years and I cannot tell you how many people have joined because of a cat in heart failure following a
                        Message 11 of 21 , May 6, 2008
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                          Hi Deda,
                          I have been a member of this list for almost 6 years and I cannot tell you how many people have joined because of a cat in heart failure following a steriod shot. I think heart failure qualifies as a serious side effect.
                          Shannon
                          ---- rzivorad <rzivorad@...> wrote:

                          > place. Besides, corticosteroids like prednisone/prednisolone don't have
                          > serious adverse effects on cats. I have experience with long-term use of
                          > prednisone in my cat and I really didn't notice any adverse effect (it
                          > could be increased appetite, maybe, but she is so poor eater that even
                          > long-term use of prednisone doesn't help). Many experienced vets, which
                          > articles on corticosteroid therapy I read, assert the same.
                          > Many regards from Deda
                        • C. Halligan
                          Hi Deda, Thank you for your comments. It is good to hear that your cat no longer has IBD. Just curious...Is kitty still using the steroid? I actually had
                          Message 12 of 21 , May 6, 2008
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                            Hi Deda,

                            Thank you for your comments. It is good to hear that your cat no longer has IBD. Just curious...Is kitty still using the steroid?

                            I actually had been weening Chloe very very slowly off the prednisone (about 2.5 months). She recently saw her integrative vet and she said that the steroid will be damaging her at a cellular level or a level that we cannot see at this time and will not see until it is too late. Vets jump on steroids because as a last resort they are wonder drugs BUT long term the effects are usually devastating, among Cushing's disease being the worst.

                            I am back to square one with food elimination and hoping the supplements will work. Cindy
                            ----- Original Message -----
                            From: rzivorad
                            To: feline-heart@yahoogroups.com
                            Sent: Monday, May 05, 2008 10:05 PM
                            Subject: [FH] Re: Appetite stimulants, useful experience



                            Hi Cindy!

                            I use the term expert to indicate person who is the most knowledgeable
                            in some area. No doubt that Mr Douglas Bronstad deserves that. The
                            therapy which is described in the article cured my cat from IBD!
                            Homeopathic methods didn't work, dietary changes failed completely.
                            Generally, you are quite right about pharmaceutical companies. You share
                            opinion with my son (or vice versa), who avers that pharmaceutical
                            companies don't want to discover medications which will really cure most
                            of known diseases (instead of just keeping us alive), because then they
                            can't sell us these (unduly expensive) medications.

                            I think that, in the case of IBD, probiotics supplement wasn't mentioned
                            deliberately, because in IBD gut flora (consisting of bacteria, of
                            course) usually overgrows, and my attack liver and pancreas through
                            common bile duct. The goal is to suppress it, not to recover it. In most
                            cases of cholangiohepatitis, there is concurrent IBD present.

                            When I told you that it was wrong to discontinue corticosteroids, it
                            wasn't because I thought you did it too fast. It was because you said
                            that you had done it fearing of adverse effects. That's not good reason,
                            because when the therapy is discontinued too early, recurrence can take
                            place. Besides, corticosteroids like prednisone/prednisolone don't have
                            serious adverse effects on cats. I have experience with long-term use of
                            prednisone in my cat and I really didn't notice any adverse effect (it
                            could be increased appetite, maybe, but she is so poor eater that even
                            long-term use of prednisone doesn't help). Many experienced vets, which
                            articles on corticosteroid therapy I read, assert the same.

                            All in all, I appreciate your message and I enjoyed reading it! Thank
                            you.

                            Many regards from Deda

                            [Non-text portions of this message have been removed]





                            [Non-text portions of this message have been removed]
                          • rzivorad
                            Hi El! I can t argue, your experience obviously shows that those vets, whose articles on the use of corticosteroids I have read, are deeply wrong. Maybe we
                            Message 13 of 21 , May 7, 2008
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                              Hi El!

                              I can't argue, your experience obviously shows that those vets, whose
                              articles on the use of corticosteroids I have read, are deeply wrong.
                              Maybe we could discuss whether it is some coincidence, but I see that
                              there are many other people with the same experience. Unfortunately,
                              there are many occasions when corticosteroids must be used, especially
                              in cats, because they are so prone to immune mediated disorders.
                              Luckily, there is alternatives to corticosteroids. Those are
                              azathioprine and cyclosporine, but it seems that corticosteroids are
                              very popular among many authors, so one can heavily find
                              recommendations of proper dosages of these two. I am sure that vets
                              also have that problem. Besides, side effects of these two
                              alternatives are pretty unknown, especially when cats are in question.

                              When we talk about therapy for IBD, it is not real long-term use of
                              prednisone, because it usually last only 8 weeks.

                              Thanks for your mail, it's worth to have information of such experience.

                              Many regards from Deda
                            • rzivorad
                              No, she doesn t use them any more. It was long ago (in 2003), and she was cured by means of therapy that was described in the article I mentioned. It lasted
                              Message 14 of 21 , May 7, 2008
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                                No, she doesn't use them any more. It was long ago (in 2003), and she
                                was cured by means of therapy that was described in the article I
                                mentioned. It lasted only 8 weeks. Since then she never had any
                                problem of that kind. It was enteritis, inflammation of small bowel,
                                and was manifested as so-called small bowel diarrhea (diarrhea which
                                consists of undigested food, smelling like the food that was eaten).

                                By the way, I prefer the term corticosteroids, in order to
                                differentiate them from anabolic steroid, which are really dangerous
                                medications.

                                Many regards from Deda
                              • rzivorad
                                Hi Katy! I have received some more mails in which their posters aver similar things. I can t argue with that, neither I want to advocate the use of
                                Message 15 of 21 , May 7, 2008
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                                  Hi Katy!

                                  I have received some more mails in which their posters aver similar
                                  things. I can't argue with that, neither I want to advocate the use of
                                  corticosteroids. I accept every experience with respect.
                                  Unfortunately, many authors whose articles on the use of
                                  corticosteroids I have read say what I said. I also read statements
                                  similar to mine on some forums. It is obvious that one has to collect
                                  as much experiences as possible. When you say that corticosteroids
                                  lower immunity, bear in mind that that is the goal of the therapy for
                                  immune mediated diseases (like IBD). Low immunity at that period can
                                  be (and usually is) compensated by concurrent use of antibiotics. We
                                  can discuss adverse effects on heart and other organs, but immunity
                                  must be lowered in the case of immune mediated diseases.

                                  Thanks for your mail. It will help me to consider the use of
                                  corticosteroids more carefully next time.

                                  Kindest regards, Deda
                                • toomany_kittys
                                  Deda, Thank you for your post and the information. Prednisolone, when given at a high dose and then weaned , i.e. in 6 mths can sometimes suppress the
                                  Message 16 of 21 , May 7, 2008
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                                    Deda,
                                    Thank you for your post and the information.
                                    Prednisolone, when given at a high dose and then weaned , i.e. in 6
                                    mths can sometimes suppress the auto-immune disease symptoms for
                                    months or years. This is done for many humans also with Multiple
                                    Sclerosis when symptoms are severe. This was the neurologist's plan.
                                    The vet had a different plan to wean slower and maybe not at all,
                                    depending on any return of symptoms.
                                    Cyclosporine and Azathiopine aren't used in this manner. They are
                                    used continually for life duration. They are also not without serious
                                    adverse affects.
                                    Currently, Jasmin the cat is being given hydrocortisone alternatively
                                    with the pred to wean her off the pred. It isn't as strong and has
                                    lesser side affects. She is also on an adrenal support for the next
                                    3 - 6 mths. The integrative vet has found that diseases that respond
                                    quickly to pred often involve the adrenal glands.

                                    I'm glad the IBD resolved itself with your cat. The yellow soft stool
                                    does indicate undigested food - the yellow is bile. Were you giving
                                    her digestive enzymes? Pancreatic enzymes? supplements for gut
                                    health? I recently had a cat have acute pancreatitis and the yellow
                                    stool that you speak of and within 3 weeks her stool was back to
                                    normal, as were her pancreatic numbers, etc.. She was given an herbal
                                    formula with digestive enzymes, adrenal support, immune support, etc.
                                    and the problem resolved very quickly. (I have many foster cats)

                                    Sometimes drugs are absolutely necessary, but often there are better
                                    solutions.

                                    El



                                    -- In feline-heart@yahoogroups.com, "rzivorad" <rzivorad@...> wrote:
                                    >
                                    > Hi El!
                                    >
                                    > I can't argue, your experience obviously shows that those vets,
                                    whose
                                    > articles on the use of corticosteroids I have read, are deeply
                                    wrong.
                                    > Maybe we could discuss whether it is some coincidence, but I see
                                    that
                                    > there are many other people with the same experience. Unfortunately,
                                    > there are many occasions when corticosteroids must be used,
                                    especially
                                    > in cats, because they are so prone to immune mediated disorders.
                                    > Luckily, there is alternatives to corticosteroids. Those are
                                    > azathioprine and cyclosporine, but it seems that corticosteroids are
                                    > very popular among many authors, so one can heavily find
                                    > recommendations of proper dosages of these two. I am sure that vets
                                    > also have that problem. Besides, side effects of these two
                                    > alternatives are pretty unknown, especially when cats are in
                                    question.
                                    >
                                    > When we talk about therapy for IBD, it is not real long-term use of
                                    > prednisone, because it usually last only 8 weeks.
                                    >
                                    > Thanks for your mail, it's worth to have information of such
                                    experience.
                                    >
                                    > Many regards from Deda
                                    >
                                  • rzivorad
                                    Hi El! I believe that autoimmune diseases, all of which respond to prednisolone or other corticosteroids, always involve adrenal glands. Adrenal glands produce
                                    Message 17 of 21 , May 9, 2008
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                                      Hi El!

                                      I believe that autoimmune diseases, all of which respond to
                                      prednisolone or other corticosteroids, always involve adrenal glands.
                                      Adrenal glands produce natural corticosteroid cortisol, which has
                                      immunosuppresive effect (among many other). It is pretty normal to
                                      suppose that there would never be autoimmune diseases if adrenal
                                      glands worked well so, being insufficiently active, they are always
                                      involved in immune mediated diseases.

                                      I must disagree about azathioprine and cyclosporine. They are
                                      immunosuppressors and are used like other immunosuppressive drugs, but
                                      with much stronger effects and, unfortunately, worse adverse effects.
                                      In cats, they are used in severe cases of lymphocytic
                                      cholangiohepatitis, feline herpetic keratitis, immune-mediated
                                      hemolytic anemia, idiopathic thrombocytopenia and so on, when respond
                                      to corticosteroid therapy is poor.

                                      There was no need for pancreatic enzymes supplement. It is used in the
                                      case of pancreatic exocrine insufficiency (which is rare in cats), and
                                      is contraindicated in acute pancreatitis. This is heart group, so we
                                      shouldn't "talk" about pancreatitis or IBD, but her stool was typical
                                      small-bowel diarrhea, not just loose, pale and greasy stool like in
                                      pancreatic insufficiency.

                                      I strongly believe in medications. When disease develops, there is no
                                      time for the use of less dangerous methods. Those methods must be
                                      applied on a long-term basis, and are irreplaceable for preserving
                                      health, but in the cases of serious diseases.

                                      < I'm glad the IBD resolved itself with your cat. >

                                      Thanks!

                                      Many regards from Deda
                                    • toomany_kittys
                                      Deda, My original stmt is below. This refers to auto immune diseases such as demylineating neuopathy which Jasmin has. As I stated, prednisolone is used in a
                                      Message 18 of 21 , May 9, 2008
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                                        Deda,
                                        My original stmt is below. This refers to auto immune diseases such
                                        as demylineating neuopathy which Jasmin has. As I stated,
                                        prednisolone is used in a very high dose for a short duration which
                                        then often suppresses the symptoms for years - not in lower doses for
                                        life. The below drugs aren't used in this manner for this condition -
                                        in extremely high dose for short duration. Please note my original
                                        stmt below 'They are not without serious adverse affects.'

                                        Cyclosporine and Azathiopine aren't used in this manner. They are
                                        used continually for life duration. They are also not without serious
                                        adverse affects.

                                        > I must disagree about azathioprine and cyclosporine. They are
                                        > immunosuppressors and are used like other immunosuppressive drugs,
                                        but
                                        > with much stronger effects and, unfortunately, worse adverse
                                        effects.
                                        > In cats, they are used in severe cases of lymphocytic
                                        > cholangiohepatitis, feline herpetic keratitis, immune-mediated
                                        > hemolytic anemia, idiopathic thrombocytopenia and so on, when
                                        respond
                                        > to corticosteroid therapy is poor.

                                        >
                                        If I recall correctly, you brought up the IBD. Believe me, the stool
                                        from pancreatic insufficiency is not always 'just loose, pale and
                                        greasy'.

                                        This is heart group, so we
                                        > shouldn't "talk" about pancreatitis or IBD, but her stool was
                                        typical
                                        > small-bowel diarrhea, not just loose, pale and greasy stool like in
                                        > pancreatic insufficiency.

                                        I completely disagree with the stmt below. In an emergency situation,
                                        medications are often important but not always 'when disease
                                        develops'. Yes, medications are important for some diseases but with
                                        many, such as IBD, alternative treatments such as accupuncture,
                                        Chinese Herbal medicines, supplements, etc. and diet changes work
                                        very well. The methods don't have to applied on a long-term basis. My
                                        HCM kitty had IBD (both diagnosed by ultrasound), and we successfully
                                        used alternative methods. He no longer needs the accupuncture nor the
                                        Chinese Herbal meds for it. The IBD has resolved itself.
                                        Also, for HCM have you read the recent post where the one cat who
                                        reacted adversely to Atenolol has had improvement with the supplement
                                        Cardio Strength? At some point, he will probably require meds, but
                                        the supplement has reversed the disease process to a degree.
                                        >
                                        > I strongly believe in medications. When disease develops, there is
                                        no
                                        > time for the use of less dangerous methods. Those methods must be
                                        > applied on a long-term basis, and are irreplaceable for preserving
                                        > health, but in the cases of serious diseases.


                                        You're right, this is a heart group. If you would like to further
                                        this discussion, feel free to email me.

                                        El
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