4/22 Billie AMPS 227 +4 184 Atopica?

http://www.felinediabetes.com/FDMB/...methylprednisolone-pills.193811/#post-2167089

Hello all!

Mega vines to Rusty recovering from his surgery and all the other kitties and beans in need of vines.

When I checked in a couple weeks ago, Billie had just started methylpred. It did not go well. She started acting very lethargic and also seemed to be having muscle weakness. I noticed her having a little trouble getting up a couple times, and she was sometimes a little wobbly when walking. I stopped the steroid (she had only been on it for 5 days) and those symptoms stopped by the following day.

The vet's next suggestion to treat Billie's triaditis (pancreatitis, IBD, liver disease) is Atopica. I'm super hesitant based on what I have read about the side effects and based on Billie's recent bad experiences with methylpred and mirtazapine. I worry that she isn't up to metabolizing these drugs. I feel like we're playing Russian Roulette every time we try a new one. And Atopica's list of side effects is quite intense. In a study of 205 cats, 35% experienced vomiting, 20% lost weight, 15% diarrhea...and 3 cats developed fatty liver disease. I'm also reading that it can accelerate cancer growth. I don't know if Billie has cancer...her IM vet thinks it's unlikely based on how how slowly her liver disease has progressed. But I of course worry about her IBD progressing to lymphoma. She has had plenty of ultrasounds and bloodwork, but I've always opted not to biopsy.

The reason to try a new med is mainly due to Billie's progressive weight loss and elevated liver enzymes. Also, she is very mildly anemic as of her most recent bloodwork from last month.

Another thing I read, though, is that Atopica is contraindicated in cats with compromised liver function...???

Her appetite has been excellent, which makes the weight loss confusing. Her BG has been stable. Occasional hairball but no chronic vomiting. Poos ranging from normal to soft. She's slowing down a bit in terms of energy level but still very engaged and seems content. Runs to the door when I get home, jumps all the way up on the back of DBF's desk chair.

If Atopica can help her quality of life, I don't want to not try it...but I worry about it making things worse. Of course, I also worry about everything getting worse if we don't explore more treatments. If anyone has experience or ideas to share, or opinions on what you would do if you were me, they're all very much appreciated!! Thank you so much!

Billie is currently taking Denamarin, Cannapet, Keppra for focal seizures (cause unknown), probiotics, and weekly b12 shots. Plus her insulin and inhaler for her asthma.

 

I don’t know anything about Atopica but I’m tagging another member that has started using it recently to share his experience with you, it may be helpful. @Sean & Rufus

I hope you find something helpful and Billie is feeling better soon.

 

Hi! I'll just share my experience with Atopica. Rufus has food allergies/intolerance and and now has inflamed GI. Vet doesn't think he has IBD/SCL based on ultrasound, but I think he does have something beyond the allergies. He also has/had pancreatitis. We tried to get him on a novel diet to no avail. Vet doesn't want him on a steroid, which I agree with (for right now). We started Atopica about 4 weeks ago I believe. Let me add that he doesn't have classic IBD symptoms. He has nausea, gas, bloating, and constipation. Now, the Atopica is supposed to "calm" the inflammation but in fact it makes him MORE nauseous. Also, he has vomited at least twice a week since starting it. Some places say give with food, others say no food within 2 hours. I wait 2 hours otherwise he will vomit. Also, Rufus has had some kidney issues before starting this drug. I will say he started Adequan about a week before it, so those were 2 new drugs to him. Between February and April his creatinine went from 1.4 to 2.2 and his bun I think from 31 to 45. First thing I did was google "meds that increase kidney numbers" and Atopica/cyclosporine came right up.

I will say it has helped with his itching, but not quite sold on the inflammation part of it. I don't know if any of this helps you, as each cat is different, but I am too concerned about the scary side effects of this drug.

Good luck!

 

Thank you Stacy and thank you Sean! It is super helpful to hear your experience and I appreciate you weighing in! Sorry to hear Rufus is struggling with some GI issues too Billie also has a history of food allergies, but luckily she has been open to novel proteins (she's currently eating Koha kangaroo pate). It's so hard to figure out what to do in these situations, especially with a med that has those side effects. Thanks for letting me know about the kidney concerns as well. I wasn't aware of that aspect, but that's a concern for us too. Billie's kidney values are normal, but she really only has one strong kidney. Her left kidney has always been abnormally small, but on her most recent ultrasound, the vet thought it looked like it was starting to atrophy. So, I definitely don't want to put her right kidney at risk since it's doing a great job holding down the fort right now.

I'm also wondering about budesonide. The IM vet is mainly concerned with Billie's liver, and not as concerned with her IBD since she doesn't have obvious IBD symptoms... but I wonder if budesonide would help her to absorb her nutrients better by addressing any small intestinal inflammation. I know that it would not help liver inflammation since it works locally, but maybe it could have some benefit and help her maintain her weight.

 

It is so hard when they have multiple issues going on. I would love to try Bude but my IM vet won't let us yet. Have you tried Young Again LID? I know it's not recommended, but at least it's high calorie food. Since her appetite is good, maybe put a quarter cup of it out. Get extra calories in her?

 

Omg!!!! I must be living under a rock... I had no idea they made a LID formula!! Billie used to eat YA in addition to wet and she LOVED it. It was my go-to when her appy was off. But, she's allergic to chicken so I stopped ordering it forever ago. I'm definitely going to order some of the LID and give that a try. She'll be thrilled! At this point, I'm all about any food that she likes, isn't allergic to, and is low carb. Thank you!

 

Glad I could help Good luck!!