Aa
Aa
A
A
A
Close
Avatar universal

Proper dosage prendisone

My 5 year old pug was diagnosed with mild ibd. The vet prescribed 10mg of prendisone 2x a day for 2 months. He only weighs 20 lbs, does that seem like too much?
11 Responses
Sort by: Helpful Oldest Newest
462827 tn?1333168952
Part 2:

Testing for IBD

    There are two different diagnostic tests that are commonly done to detect IBD.

    One test is what is known as a ‘confirming’ test, in which a biopsy is taken to assess morphologic characteristics common in the GI tracts of animals with inflammatory bowel disease. This is not my first choice because it’s expensive, invasive and involves anesthesia and the inherent risks that come with it.

    The other test, which I use often in my practice, is a functional gastrointestinal test using a blood sample.

    What we’re looking for with this test is two types of B vitamin absorption, the first of which is folate. Folate is a water-soluble B vitamin that is not easily absorbed in the small intestine unless it is deconjugated there.

    If your pet’s small intestine can’t deconjugate folate, meaning it can’t break it down into an absorbable form, she can end up folate-deficient, in which case her blood test will show low or suboptimal levels of folate.

    A low folate level means either your pet’s assimilation and absorption of nutrients is poor, or her body is challenged by the deconjugation process, indicating a disease or disorder of the small intestine.

    If your pet’s folate is high rather than low, it indicates another type of problem. Your pet’s small intestine contains a small amount of bacteria critical for the production and assimilation of certain B vitamins. If this bacteria blooms into an overgrowth, your pet can wind up with high folate levels and a condition known as SIBO – Small Intestinal Bacterial Overgrowth.

    The second blood test I use to assess GI function involves another B vitamin called cobalamin, which is bound to protein.

    Cobalamin is released from protein through a complex series of events that starts in the stomach and finishes in the small intestine.

    If cobalamin levels are low, we can assume this complex process is not occurring optimally. Cobalamin levels are a measure of digestion. This condition of maldigestion can sometimes also involve the pancreas. The disorder is called EPI – Exocrine Pancreatic Insufficiency and can be diagnosed via another GI blood test called a TLI (Trypsin-like Immunoreactivity).

    If you suspect your pet has IBD but you’re not interested in doing a biopsy at this point, ask your vet to perform functional GI testing to determine a diagnosis.

    In my practice, I also do two additional functional tests, TLI and PLI, which assess pancreatic function. Secondary pancreatitis is a very common condition in IBD patients, so assessing your dog’s or cat’s pancreatic function is also important.

    These functional GI tests are available through the gastrointestinal lab at Texas A&M University.

Dietary Recommendations for IBD

    Upon diagnosis, your veterinarian will probably tell you to feed a bland diet if your pet is symptomatic with vomiting, diarrhea or soft stool with mucus and/or blood.

    My idea of a bland diet is different from a traditional veterinarian’s. I recommend ground cooked turkey and canned pumpkin or cooked sweet potato. I don’t recommend the traditional beef and rice. Beef is high in fat, which can exacerbate GI inflammation and pancreatitis.

    Rice is a complex carb which can be fermented in the GI tract, causing gas, which can lead to additional digestive upset.

    I recommend a grain-free, bland diet because in my experience it’s more suitable to pets with active symptoms of IBD.

    While feeding your dog or cat a bland diet, you should be thinking about what’s next for her in terms of nutritional requirements. Bland is fine for a short time, but balance in the diet is crucial

    I recommend you work with an integrative veterinarian to select a novel protein source -- one your pet has either never consumed or hasn’t for a long while. This will give the GI tract and your pet’s immune system a good rest.

    You’ll also want to select a novel vegetable or fiber source as well, to create an anti-inflammatory menu that will facilitate healing within both the large and small intestine.

    An integrative vet can help you build a comprehensive protocol for your pet that addresses not only dietary issues, but also vaccinations, the use of drug therapy, and any potential toxins in your pet’s environment or lifestyle that could be contributing to unaddressed inflammation.

Helpful - 0
462827 tn?1333168952
From Dr. Karen Becker at Mercola Healthy Pets:   (Part 1)

Dr. Becker's Comments:

    Inflammatory bowel disease (IBD) is a condition of inflammation of the intestines.

    There are four common types of IBD, classified by what kind of white blood cells infiltrate the intestine: lymphocytes, plasmacytes, eosinophils and neutrophils. Without a doubt, the most common cause of IBD in pets is lymphocytic-plasmacytic enteritis, gastritis and colitis.

    If your pet’s intestines are inflamed long enough, the situation can create a host of other debilitating health conditions.

IBD and Leaky Gut

    Both cats and dogs get IBD. Both are susceptible to dysbiosis or ‘leaky gut,’ which means the balance of bad to good intestinal bacteria gets out of whack.

    Leaky or permeable gut is a condition in which inflammation weakens the tight junctions of the cells of the GI tract, allowing partially digested proteins and potential allergens to escape into your pet’s bloodstream.

    Allergens in the bloodstream trigger a systemic immune reaction – your pet’s body senses foreign invading substances and mounts a powerful defense. The result is allergies or worse – autoimmune or immune-mediated disease. A simple explanation for this condition is that your pet’s body is attacking itself.

IBD Leads to Secondary Infections, Organ Degeneration, Nutritional Deficiencies and Even Cancer

    Secondary infections are very common in dogs and cats with inflammatory bowel disease. This is the result of not having a balanced, healthy digestive system.

    Over half your pet’s immune function is located in his GI tract, so if the intestines are inflamed and compromised, the immune system is compromised right along with it.

    Secondary organ degeneration is common with IBD, especially in the kidneys and liver.

    Nutritional deficiencies are also typical in IBD pets because inflammation disrupts the normal absorption and processing of nutrients from food.

    With kitties, there’s a correlation between GI cancer (lymphoma of the GI tract) and chronic IBD.

A Common Cause of IBD – GI Parasites

    There are a few common causes of inflammatory bowel disease in dogs and cats.

    One that is often overlooked is the presence of parasites.

    My estimate is the vast majority of puppy mill pets and abandoned/rescued animals left at shelters are positive for parasites – roundworms, hookworms, tapeworms, coccidia, and Giardia. Parasites cause GI inflammation.

    Another source for parasite infestation is in litters whose mothers were not tested or treated prior to being bred. Responsible breeders arrange for testing and deworming of females before they are bred, which insures litters will be parasite free.

    Less responsible or unknowledgeable breeders don’t take the same precautions and end up selling litter after litter of puppies and kittens that have GI parasites.

    The next problem arises at the veterinary clinic, where broad spectrum dewormers are given to infected animals at regular intervals until 16 weeks. At the end of the 16 weeks, the pets are re-checked to see if the parasites are gone.

    But here’s the issue: if the specific parasite isn’t identified, it may not be killed by a broad spectrum dewormer. So pets wind up with several weeks of unnecessary medication that doesn’t even solve the problem.

    Many dogs I see at my Natural Pet hospital have been dewormed three or four times but are still having problems. When I check fecal samples for these pups, I often find they are coccidia or Giardia-positive. Broad spectrum dewormers don’t take care of these particular parasites. Giardia, for example, causes intermittent diarrhea and chronic low-grade inflammation of the GI tract. It is not responsive to the dewormers most vets prescribe.

    A saner, safer approach is for your vet to do at least three fecal analyses one month apart to determine the type of parasite and to confirm your pet is rid of them. Selecting the appropriate dewormer for the type of parasite, and treating the pet until the parasites are completely resolved is a crucial part of decreasing GI inflammation and preventing full-blown IBD.

    By the time these unfortunate pups are seen at my practice, they are over 16 weeks old, with intermittent soft stools indicating GI inflammation, and they typically still have a parasite problem which requires treatment before any other symptoms can be resolved.

Another Root Cause – Antibiotics and Steroids

    Another of my frustrations is that animals with low-grade GI inflammation are treated with antibiotics by the traditional veterinary community.

    Antibiotics are a second common trigger for inflammatory bowel disease.

    GI antibiotics kill the healthy bacteria right along with the bad guys. When all bacteria is obliterated from your pet’s gut, the regrowth often results in an imbalance featuring too many gram-negative, unhealthy bacteria or opportunistic yeast and not enough of the friendly variety. This is the definition of dysbiosis.

    Now we have a 16+ week old puppy or kitten that has had several weeks of GI inflammation, ineffective deworming treatments, one or two rounds of antibiotics which have obliterated all the bacteria in his GI tract, and no re-seeding of bacteria with an appropriate probiotic to insure a healthy balance.

    This little guy is well on his way to low-grade GI inflammation and IBD.

    I’ve also seen dogs and cats that at six months of age are already on Prednisone therapy for GI inflammation. Prednisone is an immunosuppressive steroid, which turns the immune system down or completely off, wiping out troublesome symptoms and giving the appearance of a ‘cure.’ Unfortunately, this treatment doesn’t do a thing to uncover the root cause of the GI inflammation and ultimately postpones true healing.

A Third Culprit: Food Intolerance

    In my practice I see many pets brought in for intermittent soft-to-watery stools, a situation many pet parents dub ‘sensitive stomach.’

    Typically, this ‘sensitive stomach’ means the dog or cat cannot undergo any sort of dietary change without major GI consequences. This isn’t what nature had in mind when it built your favorite furry friend.

    Just as you are designed to eat different foods at every meal without GI disturbance, pets with healthy, resilient GI tracts should be able to tolerate changes in the food they eat without negative consequences.

    Probably more than half the pet owners I talk to assume it’s normal for their dog or cat to have GI sensitivity to changes in diet. But what’s really going on is the animal’s gut is in some way compromised and therefore cannot withstand dietary variety. It could be a low-grade inflammation that has been present for weeks, months or even years by that time.

    Food intolerance or sensitivity can begin with a poor quality, non-species appropriate diet – one that is high in unnecessary carbohydrates. Processed pet food containing a lot of corn, wheat or rice can create inflammation in the gut of your carnivorous dog or cat, designed to digest meat – not grains.

    I also have clients that feed a raw, species-appropriate diet without carbohydrates, which is wonderful, except they feed the same protein source for weeks, months or years.

    Many animals (including humans) develop hypersensitivity to a food they eat over and over again. Inflammation is the result and can lead to IBD.

    So overfeeding too much of even the right foods can lead to problems in the digestive tract.

Helpful - 0
Avatar universal
They said they tested him for Epi and it was negative. I was the one who suggested it to them. He did test positive for Sibo, but they stopped treating him for it after he started vomiting when he was on flagyl to treat it. I asked them what they were doing about the sibo and they said right now nothing, we want to put him on the prednisone and see how he does on that. I have not given it to him as the dose they prescribed seems way to high. The vet is on vacation until Monday and I will readdress all my concerns with her then. I shouldn't have to be the one suggesting things to them, it should be the other way around. As I said, this is my third vet I have seen, and I have yet to find one that really cares.
Helpful - 0
462827 tn?1333168952
   Found this:
             SIBO & B12 Deficiency:  EPI's Nasty Companions

              SIBO (Small Intestinal Bacterial Overgrowth)
It's been said that 70% of dogs with EPI also develop a condition called "SIBO."
Has some of the same symptoms as EPI
Occurs when undigested food sits in the small intestine and is attacked by "bad" anaerobic bacteria
Some bad bacteria are always present, but are normally held in check by the "good" bacteria
Since bad bacteria thrive on undigested food (especially starch, sugars, and grains), this causes an explosion in their growth
Can result in permanent digestive problems and food allergies if not treated timely. Results in nutrient malabsorption because the bad bacteria...
Compete for calories and nutrients
Produce toxins
Damage small intestine's absorptive surfaces (mucosa)  (photo)
Cause symptoms in your dog that lead to...
Reduced food intake (due to reduced appetite)
Altered food intake (which can change the nutrient balance)
Reduced immunity
Also sometimes referred to as "Antibiotic-Responsive Diarrhea" (ARD)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
B12 Deficiency
It's been reported that almost 50% of dogs with EPI lose the ability to process vitamin B12.
B12 is necessary for many things
Essential for digestion
Deficiencies can lead to impaired cognitive function due to neurological complications
An EPI dog that's deficient in B12 will have difficulty gaining weight, even when on enzymes
An EPI dog is considered at high risk for B12 deficiency (if not immediately, then eventually)
Biggest long-term survival risk for EPI dogs is caused by untreated B12 deficiencies
Helpful - 0
441382 tn?1452810569
OK.  Have them do a pancreatic enzyme test.  When my Kate got sick this is how she started and it took the vet more than two years to diagnose Exocrine Pancreatic Insufficiency (EPI) but by then it was too late to save her.  They misdiagnosed it first as diabetes, then as Cushing's Disease, and finally, after doing exhaustive research online, it was I who came up with EPI and asked the vet if this could be the problem.  He literally did a facepalm and said he didn't know how he could have missed it.

When you mentioned the color of his stools, the consistency and the fact that there was undigested food in there I immediately flashed back to when Kate first got sick.  If you catch this early on you can simply supplement him with the enzymes he needs to properly digest his food.  If you are not seeing any appreciable improvement with the current treatment or if it seems to get better and then start again, please ask him about the EPI.

Please keep us updated on his progress.

Ghilly
Helpful - 0
Avatar universal
Yes, in the very beginning I was cooking him boiled hamburger and rice. He was still having bouts of diarrhea even on that, but he wasn't pooping six times a day, like he is now. In the past I could always clear him up on a few days of that. He has been on Royal Canin wet food for about 6 weeks. I first tried the fish and potato, and just switched him over last week to the venison and potato. His stools are the same, they are semi soft and orange with mucous and I can see undigested food in it. He has had two fecal exams and I have heard that it is hard to diagnose, but it has come back negative,so how do you know if he has that? His bloodwork showed pancreatitis when all of this first began, but I had him tested again about 3 weeks ago and his level was back to normal. He did test positive for an elevated folate level, which the vet said was from small intestinal bacterial overgrowth. They treated him for a week, but stopped after he began to vomit from the flagyl. He is no longer being treated for that. I started adding a probiotic to his food yesterday, so I hope this may help him
Helpful - 0
462827 tn?1333168952
Hi Leigh...Have you ever tried to cook homemade meals for him during any of this? If so, did he get better?  Are all the above packaged foods you listed, dry foods?

Which food has he been eating for the two months? Are you saying he has gotten worse on the Royal Canine? I assume it's dry food, also?

Has anyone tested or treated him for Giardia? It's sometimes hard to find on a Fecal sample....
Did the rest of his bloodwork look good other than the mild IBD? Anything else off, on his lab report?
Thanks, Karla
Helpful - 0
Avatar universal
Thanks for your response. Before all of this happened he was eating Wellnes simple solutions lamb and rice with some california natural herring sweet potato kibble. We also were giving him alot of treats, like turkey breast, chicken, roast beef etc. He has not had one thing for two months except his dog food with some added sweet potato, and a little cottage cheese. I wpuld love to switch his food, but I am so afraid to make things even worse then they are right now.
Helpful - 0
462827 tn?1333168952
Hello & welcome....I personally think this is diet related......Do you mind me asking what food & treats he was eating before/when this all started to happen? How long has he eaten it?   Thanks, Karla

P.S. I think the Pred dose is too high, also......5 mg 2@day would be plenty for a 20lb. dog! This would be the initial dose for just a few days, then dropped down to 5mg once a day then every other day & so on........
Helpful - 0
Avatar universal
They mentioned that they would be monitoring him throigh bloodwork. I am very worried about giving him the prednisone. He was originally diagnosed with pancreattitis, so all the more reason I am leary about puting him on it. He has been suffering for over two months with nauseau, lethargy, loose stools and constant lip licking and excessive saliva. We nave done numerous blood tests, urinalysis, fecal, tested for addisons, xrays, epi. He did test positive for SIBO and was treated for a week of flagyl, but started to vomit and they were comcerned that it was from the flagyl, so they took him off it. He had an endoscopy and I was told by the vet that she saw inflammation in his upper intestine. When the biopsy came back, she was surprised that it only showed up as mild inflammation. The other problem that I am dealing with is that he is on Royal Canin hypoallergenic vet food and ever since I put him on that food he has been pooping at least six times a day and they are orange and mucousy. They don't want me to switch his food right now. He has also lost 2 lbs since this all started. I am so frustrated and worried about my poor dog. This, btw is my third vet that I have seen for his condition. I have spent over $5000 and don't know what to do anymore.
Helpful - 0
441382 tn?1452810569
This is a difficult situation you are in.  Two months is a long time for a dog to be on steroids.  Has the vet said anything about doing periodic bloodwork during that time?  It would be a good idea because unfortunately, IBD really only responds to steroid therapy, but dogs do not tolerate steroids real well and a number of problems can develop because of their use.  A short-term regimen (a week or so) is usually tolerated fairly well, but longer than that puts you in a position where your dog is flirting with developing diabetes mellitus, Cushing's Disease, pancreatitis, or several other problems.  By doing bloodwork at least twice during the two months he's being treated you can keep track of how his system is tolerating the steroids.  Weaning him off at the earliest sign of problems would be possible if you're keeping track of how he's responding.

The dosage does sound high to me.  The usual dosage for a 20 pound dog is 1.25 to 5mg per day.  He would be getting 4 times that much.  That seems excessive to me, especially for such a long time.  I could see working up to that much and then weaning down from it, but not starting at that dose and just keeping it going for that length of time.  Did the vet say anything about weaning him off the steroids?  

I had a cat that had IBD and she had to get a steroid shot once a month.  Hers was chronic so no matter what we did it was not going to resolve, she got her shot once a month simply so that she didn't have liquid diarrhea on a constant basis.  The steroids enabled her to have (almost) normal bowel movements until juuuuuust about the end of the month when it was wearng off and then it would take two or three days after the shot for things to return to normal again.  We did this every month for six years until she developed diabetes from it and we lost her to complications from that.   My reason for telling you the story was that I guess I just don't understand his rationale for keeping him on such a high dose for such a long time right from the get-go without first seeing what the response to the drug is going to be.  It may be that the steroid knocks out the inflammation early on and he can be weaned off after a very short time.  ESPECIALLY since you said that it is only MILD IBD.  

Please keep us updated on how things are going.  Do not be afraid to ask your vet questions or to question why he is doing what he is doing.  Remember, even though he's the one who went to vet school, HE works for YOU.  If you are not getting satisfactory answers to your questions, get a second opinion.
Helpful - 0
Have an Answer?

You are reading content posted in the Dogs Community

Top Dogs Answerers
675347 tn?1365460645
United Kingdom
974371 tn?1424653129
Central Valley, CA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Members of our Pet Communities share their Halloween pet photos.
Like to travel but hate to leave your pooch at home? Dr. Carol Osborne talks tips on how (and where!) to take a trip with your pampered pet
Ooh and aah your way through these too-cute photos of MedHelp members' best friends
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.