My nine-year-old Orange Tabby has vomited periodically most
of her life. Within the last few months, her
vomiting has increased to the point that I had to
rush her to vet ER. They hydrated her, ran
blood tests, xrays, etc.

Jill
Portland, Oregon, USA

It sounds like you and your cat are going through quite an ordeal!

Many things can cause cats to vomit. Food intolerance, metabolic disorders (such as liver or kidney disease), foreign objects in the stomach, neurological problems, heartworm disease, intestinal parasites, tumors, problems with the pancreas and exposure to poisons are among the many offenders, and this list is far from complete.

However, in cats that have a long history of vomiting that worsens precipitously I am often suspicious of a syndrome called inflammatory (or infiltrative) bowel disease. The syndrome is also known as IBD.

Cats with IBD suffer chronic irritation of the intestines. This leads to vomiting, diarrhea, or both.

Diagnosing IBD can be difficult. A biopsy of the intestines (by means of surgery or endoscopy) is the most definitive method, but it is very invasive and I rarely recommend it.

However, you do not mention that your cat has had an ultrasound of her abdomen. Ultrasound is a powerful, non-invasive and painless diagnostic technique. Skilled ultrasonographers can sometimes diagnose IBD. And they almost always offer insight into the cause of chronic vomiting. I would recommend abdominal ultrasound as the next step for your cat.

If your cat is diagnosed with IBD, several treatment options exist. Dietary modification is the mainstay of treatment, but it sounds like you may have exhausted this possibility. Probiotics help many cats; yours, unfortunately, seems refractory to this treatment.

I have seen many cats with chronic vomiting respond favorably to treatment with medicines that modulate the immune system. Prednisone is most commonly used. As I have mentioned before on this blog, prednisone is a double-edged sword. However, you may want to discuss a trial of the medicine with your veterinarian. It may help solve the problem.

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My Lhasa Apsos have allergies and have been tested.
I tried Atopica with no luck and it was expensive.
My vet said that giving my dogs predisone every
other day would not hurt them. Your thoughts
please.

Janeen
Mililani, HI

Allergies are frustrating, to be sure. Just ask anyone who suffers from hay fever. Allergies can make you miserable, and, for now, they cannot be cured. People actually move across the country to try to escape from their allergies. That is part of the reason why Arizona’s population has grown so rapidly in recent decades.

In pets, allergies usually cause skin problems such as hair loss, red skin, and itching. Ear infections also are common.

As I have mentioned, at the current time there is no cure for allergies. But there are several treatments. Some, such as flea control, soothing baths, omega-3 supplements, and hypoallergenic diets are simple and safe, and should be considered in every pet with allergies.

Others treatments, such as antihistamines, are generally safe, but not always effective. They are appropriate for some, but not all, allergy sufferers.

And then there are the bigger guns: allergy testing, followed by allergy shots, may help some pets. You mentioned that you have gone down this road without success. Genesis is a topical spray that significantly helps some pets. Atopica is another potent allergy treatment. It is expensive and generally effective, but it does not work in every pet.

Finally, there is the biggest gun of them all: prednisone. Prednisone is an anti-inflammatory steroid that is related to cortisone. It is simultaneously the best and the worst drug ever invented. No drug is more effective at treating allergies in pets. But prednisone also can cause a large number of side effects.

Pets who take prednisone long-term may suffer increased thirst, increased urination, weight gain, and personality changes. They may develop bladder or sinus infections. They are at risk of liver damage and diabetes.

However, not every pet who takes long-term prednisone suffers from these issues. Some pets can take prednisone for years without developing any problems. Others cannot tolerate the medicine for even a week.

So, to answer your question (finally): it may be safe for your dogs to take prednisone every other day. Or it may not. It depends on your dogs.

Here is what I recommend you do. First, exhaust all of the other treatment options that I have mentioned above, and make sure that none of them works.

If it turns out that only prednisone can make your dogs comfortable, then use it. But use the minimum effective dose. Monitor for the side effects that I mentioned above. And, very importantly, run comprehensive blood and urine tests every three to six months to ensure that the medicine is not having adverse internal effects in your dogs.

Finally, remember that some pets outgrow allergies over time. It may be worth your while to experiment (under the supervision of your veterinarian) with reducing or eliminating their prednisone doses periodically.

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