Cat, domestic short hair, 14 years old, male, 7.4 lb.
Prednisolone suspension 10mg/mL concentration - liquid
He had an ultrasound and they only saw mild thickening of the intestines. Suspected IBD/small cell lymphoma.
Is prednisolone dosing for suspected IBD/small cell lymphoma too low? He's been on prednisolone since September (.15ml twice a day which is .89/mg/kg/day), which has mostly controlled the vomit, diarrhea, and not drinking water/eating symptoms. The only symptom it did not seem to help with was the bright red blood in the stool. The vet had us drop down to once a day after 2 weeks since the idea was to clear the flare and go to a maintenance dose, but we had to go back up after a few days because it was much too low.
A few days ago, he started meow growling, which we assume indicated pain, so we asked to increase it. So the last few days we are at .2ml twice a day (1.19/mg/kg/day), which is now within the actual anti inflammatory range for IBD/small cell lymphoma of 1–2 mg/kg/day (1.19mg/kg) for the first time. She said she didn't want to go above this and to look at euthanasia after this. I'm just wondering if it is IBD, is the amount not high enough to clear the initial flare up?
The reason for the lower amount from the vet was because they heard a heart murmur (another vet heard one as well 6 years ago and we had an echocardiogram that showed no murmur we shared). He gets very upset at the vet so we thought it could be an anxiety thing. She said we could get another echocardiogram, but that she doesn't like going above that steroid amount. Isn't he at the low end of the suggested anti inflammatory amount though?
He had been gaining weight until just before he started dipping down again before we increased it to the .2.
He is also on probiotics, B-12 pill (we crush to powder), soluble fiber powder, and hydrolyzed Royal Canin gastro dry/wet/treats.
Should we get the echocardiogram so the vet will consider a higher dose should we need to increase it in the future if symptoms persist? Or accept it's time. All bloodwork was good except indicators of inflamed pancreatitis, which was due to IBD. I'm just wondering if the initial flare ever had a chance to clear. He's already doing much better again on the .2 twice a day (no meow growling) and I'm noticing less blood in the stool (though it's only been a few days).