best way to taper off pred?

Hi everyone, hope all you & your kitties are doing well.

My guy has been on one 5mg Prednisolone twice a day for many months. The Doc says to cut back to one a day, but, gave no instructions on how to safely do it. I did not think to ask until I got home. Any suggestions?

 

I do not fully understand your question. You pick a day and only give one pill a day at the same time each day. Did the vet say how long on the SID dosing? I hink my vet had be do 3 day of SID and then four days of every other day.

 

If I can explain more clearly...Do I just stop giving one at night or do I cut the night one to 1/2 for a couple of days, then 1/2 every other day for a couple of days then eliminate the night dose all together and just give the day dose?

Hope I did a better job explaining..sorry

 

Just stop giving one.

Don't cut in half and give 1/2 2x/day.

Smokey's vet said pred works best when given as a 'large' dose all at once.

 

I thought you had to taper off to avoid renal failure. So I was going to taper off over a period of four days the one I was eliminating.

 

I suppose that would work.

One whole pill once per day. The other one 3/4, the 1/2, then 1/4, then 0.

 

Hi,

As a long time consumer of Pred myself........Cortisone preparation should never be stopped abrubtly (unless the Tx was very short duration). Cortisone is a natural nessisary hormone produced by the outer layers of the adrenal gland. Like all hormones it is tightly controlled by a delicate monitoring and feedback system between the hypothalamus, the pituitary and the adrenals. The hypothalamus "monitors" the level of cortisol in circulating in the blood and sends messages to the pituitary telling it rather more or less is needed. When more is needed the pituitary sends out the signal telling the adrenals to produce more. When Prednisone is taken consistantly the hypothylamus detects an adequate level of circulating cortisone and stops sending signals to the pituitary, which in turn "rests" and doesn't stimulate the adrenals. When the Prednisone is suddenly stopped the body may be unable to immediately start the system back and meet the body's requirements for cortison. The result can be life threatening, cortisone is important for maintaining blood pressure, helps digestion, helps release stored energy (mainly glucose) for the body to use, and helps control the immune system. In addition the sudden withdrawl of cortisone can lead to sudden worsening of the condition it was used to treat. It has powerful anti-inflammatory properties and supresses the activity of the immune system (which is why it is used to treat autoimmune conditions and allergic reactions) suddenly removing it could cause a rebound of the immune response and inflammation.

Depending on the overall dose that was being given and for how long it usually best to decrease in steps. Generally stepping down every 3-5 days, larger steps at first and smaller steps as the dose gets smaller. this gives the hypothalamus-pituitary-adrenal axis time to "wake-up" if you will and begin controlling the body's natural production of cortisol again.

A dose of 5mg per day is a relitively low dose so chances are the body is not completely out of the loop I would suggest as Karen wrote (3/4, 1/2, 1/4 of the dose) holding each dose for about 2 days. Depending on haow many tablets you have left you could even give the 1/4 dose every other day for 3-5 days. This is the best way to prevent the condition that was being treated from flairing again.

 

Yes and thank you, all.

Bert has been on (2) 5 mg a day for what seems like a year. The other night the vet said just stop one dose and just give him one per day. Now I have what I think is a good vet, but, just stopping one did not sit right with me so I started backing off one in stages.

It's a catch 22 because what he has is being worsened by the pred and yet I did not think it was safe just to stop one dose cold. If he did not have this conditon I would have just given the night one every "other" day for three doses, then a half every other day for three doses then a half every third day for three doses and one quarter for a couple then stop. but, i have to do it a bit faster.