Severe feline indolent ulcers and pancreatitis

RE: Severe feline indolent ulcers and pancreatitis

Anthony Todd — Wed, 27 Sep 2017 00:05:01 GMT

Is there any evidence that some corticosteroids are more diabeticogenic than others? if not then using one of two that are claimed to be more effective might be better? [and easier for owner compliance]

Cats on megestrol did usually put on weight if on it for long.... er, and drink more [which now rings alarm bells].

I believe that there is evidence that the diabetic effect will wear off when dosage ends and, AFAIK, none of mine became permanently diabetic , not that I ever noticed, nor did the owners.

This is supported by references if you need them.

RE: Severe feline indolent ulcers and pancreatitis

Kara Gibson — Tue, 26 Sep 2017 16:55:13 GMT

That's useful advice, I will assess the cats pancreatitis test and ultrasoudn but will likely start back on steroids alongside appropriate parasitic control. This cat absolutely needs treatment, they are some of the worst ulcers I've seen and are very erosive and he usually takes quite high odse of preds to resolve them. I am also wondering whether some of the changes in his weight are associated with being on or off steroids!

RE: Severe feline indolent ulcers and pancreatitis

Martin Atkinson — Tue, 26 Sep 2017 15:50:01 GMT

[quote user="Anthony Todd"]

[quote user="Martin Atkinson"]That is my last word on the subject however much anyone goads me. [/quote]

[not a goad, just a question]

How, then, do you treat "rodent ulcers" or whatever they're called now?

[/quote]Eosinophilic ulcers as you ask. The answer is in most cases I don't: they are of more concern to the owner than the cat, they are usually painless, they are frequently self limiting and wax and wain but if I have to because they are a major inconvenience to the cat then with the minimal dose of alternate day preds needed to suppress them with a major consideration for other predisposing factors such as good parasite control.

RE: Severe feline indolent ulcers and pancreatitis

Anthony Todd — Tue, 26 Sep 2017 14:30:01 GMT

[quote user="Martin Atkinson"]That is my last word on the subject however much anyone goads me. [/quote]

[not a goad, just a question]

How, then, do you treat "rodent ulcers" or whatever they're called now?

RE: Severe feline indolent ulcers and pancreatitis

Martin Atkinson — Tue, 26 Sep 2017 14:00:02 GMT

[quote user="Anthony Todd"]Some supporting evidence would help this perennial statement.[/quote]I knew you'd take the bait and there is little point prolonging this particular argument, as you say it is perennial) but the evidence is in the cases I've seen, I don't need to see any other (DM will post some sarcastic comment no doubt about anecdote) but my own eyes are enough for me. However just to confirm this, the first cat I've treated with depomed for many a year for dermatitis against my better judgement because the client is incapable of giving any topical or oral medication has developed diabetes. Ovarid has been banned for donkey's years here.

That is my last word on the subject however much anyone goads me.

RE: Severe feline indolent ulcers and pancreatitis

Anthony Todd — Tue, 26 Sep 2017 13:15:21 GMT

[quote user="Martin Atkinson"]Arrh... so now we're going to give it diabetes and mammary tumours instead of pancreatitis.[/quote]

Some supporting evidence would help this perennial statement.

This may be where the rumour started.

Morphologic changes in the mammary gland of megestrol acetate-treated and untreated cats: a retrospective study.

Hayden DW1, Barnes DM, Johnson KH.

Vet Pathol. 1989 Mar;26(2):104-13.

There are case reports after prolonged use which resolved when the drug was discontinuied

RE: Severe feline indolent ulcers and pancreatitis

Martin Atkinson — Tue, 26 Sep 2017 13:08:49 GMT

[quote user="Judith Archbold"]I agree with Anthony. I would have used a course of Ovarid ( back in the day)[/quote]

[quote user="Beats"]

I would give steroids at a decent dose and effective fleabite prevention treatment...depomedrone...

[/quote]Arrh... so now we're going to give it diabetes and mammary tumours instead of pancreatitis.

RE: Severe feline indolent ulcers and pancreatitis

Michael Woodhouse — Sun, 24 Sep 2017 22:44:59 GMT

+1 on depomedrone

RE: Severe feline indolent ulcers and pancreatitis

Judith Archbold — Sun, 24 Sep 2017 15:33:51 GMT

I also agree with Andrew....I was told to take a feline lipase snap test result with a pinch of salt. If the cat isn't showing clinical signs of pancreatitis ( cue everyone telling me that cats are stoic and show no signs of pain...) then it probably hasn't got pancreatitis.

RE: Severe feline indolent ulcers and pancreatitis

Judith Archbold — Sun, 24 Sep 2017 15:31:21 GMT

I agree with Anthony. I would have used a course of Ovarid ( back in the day) as it worked! Nowadays there is the human mini-pill alternative which we discussed on a previous forum .....I Think it was CERELLE 75ug tablets ...but I can't remember the dose that was advised. I'm sure someone will remember.

RE: Severe feline indolent ulcers and pancreatitis

Beats — Sun, 24 Sep 2017 10:37:32 GMT

I would give steroids at a decent dose and effective fleabite prevention treatment.

depomedrone or oral dex-liquid easier than pred tablets in a cat that's not eating well with a sore mouth (or indeed even in a cat that is eating well without sore mouth often )

Dave

RE: Severe feline indolent ulcers and pancreatitis

Evelyn Barbour-Hill — Sat, 23 Sep 2017 21:37:11 GMT

[quote user="Anthony Todd"]

I assume this is what used to be called a "rodent ulcer"?

A photo would help but, assuming it is, give it 5mg megestrol weekly until resolution, never failed for me even after Dmed did.

[/quote]

Often failed for me. Sorry.

RE: Severe feline indolent ulcers and pancreatitis

Anthony Todd — Sat, 23 Sep 2017 17:16:05 GMT

I assume this is what used to be called a "rodent ulcer"?

A photo would help but, assuming it is, give it 5mg megestrol weekly until resolution, never failed for me even after Dmed did.

Ignore my inevitable, unqualified or argued one star when you, and the owner, are considering euthanasia and give it a try.

Just let others know on here when, or if, it works or not.

RE: Severe feline indolent ulcers and pancreatitis

Andrew Kent — Fri, 22 Sep 2017 19:32:24 GMT

Hi Kara,

I am always a little cautious in interpreting an abnormal fPLI in the absence of other supportive evidence so for me this cat may or may not have had pancreatic disease.

Even if it did, in cats I don't see this as an immediate contraindication to steroid use. We often suspect pancreatic disease is associated with inflammatory gut/liver disease so often they do end up on steroids to control that aspect.

So I agree in an ideal world that you might pursue investigation into that - but equally if that is declined and with the signs you describe I wouldn't have major concerns about using pred in this case.

Andy