Respectfully submitted by: Austin Dudzinski, fourth-year pharmacy student at University of Nebraska Medical Center College of Pharmacy
The first line therapies for severe inflammatory bowel disease in cats and dogs are the commonly prescribed glucocorticoids, prednisolone and prednisone. These medications have been proven to be effective in this disease state by reducing inflammation and subsequent irritation in the gut. However, chronic use of these steroids can result in significant side effects, which can contribute to the deterioration of the health and well-being of your feline friends and canine companions.
Common side effects associated with chronic steroids use include but are not limited to the following:
- Chronic infections including urinary tract infections in up to 30% of patients, opportunistic or secondary bacterial infections, fungal infections, and the development of adult onset demodectic mange
- Deterioration of the skin or poor/thin hair coats
- Poor wound healing
- Development of obesity/diabetes through increased hunger
For your patients that are experiencing significant side effects from prednisolone or prednisone, it may be worth it to consider a trial of budesonide!
The beauty of budesonide stems from its chemical structure. Certain functional groups on budesonide cause the molecule to be poorly absorbed from the GI tract, thus leaving more active compound to work where you want it to work…in the gut! With less systemic exposure to this steroid, your patients should experience fewer side effects!
Budesonide may even be first line therapy for your patients with comorbid diabetes! Budesonide seems to reduce the rate of hyperglycemia related to steroid ingestion.
Consider budesonide 3 mg/m2 PO q 24 h for dogs and 1 mg/m2 PO q 24 h for cats with severe inflammatory bowel disease. Ask your friends and healthcare professionals at Essential Pharmacy Compounding (EPC) to make a formula tailored to your patient’s needs.
EPC is accredited by the Pharmacy Compounding Accreditation Board (PCAB) in non-sterile and sterile compounding. EPC delivers medication to patients in all 50 states including controlled and chemotherapy medication.