Locum vet went on a rant about how we 'must' get Swampy off steroids and OH believes her (he thinks Swampy takes too many meds, but that is because he is old and ill with a variety of problems) so we had a bit of an argument. I know they are bad for his CRF and I wish he didn't need them, but I think he does.
He gets so floppy and won't eat, purr or be interested in anything if he doesn't have any. He's been on them for 13 months now since his accident. He's now on 1 1/2 every 48 hours.
She (vet) is an eye vet primarily so noticed that his ulcer isn't healing (steroids and CRF the reason) but that he has learnt to live with it. His eye is mostly closed and the 3rd eyelid covers the ulcer area. He has abx ointment which helps to soothe and he doesn't rub it. I know they are bad for his kidneys and if he just had CRF he wouldn't be on them. So is Selgian bad for his CRF but he needs it. She says that his sore tum is made worse by them too. I said that he wouldn't eat or purr without them and that - vitally - he wouldn't walk at all. That would mean that his back legs could just give way, as the 10 days when he was banned from walking after his chest flooded has made his legs so much weaker.
She doesn't think it is important that he would just lie there and not purr as he should eventually adjust. She made me feel as if I am deliberately poisoning him and making his CRF worse faster. She said he could have some time left that I am denying him by keeping on the steroids. It's true that the steroids are the first drug I hope he keeps down, as they cheer him up so much. So what if they mask if you have a terminal illness. The situation's very difficult.
She compounded my confusion by declaring that his snotty nose (it's very snotty today) wasn't that significant. It is what is making him vomit up his food! Then tells me to feed him as much as possible today as he has lost yet more weight, he is down now to 3.85 kgs from 4kgs. That's the least he has ever weighed since he was a kitten. He did vomit up 2 meals yesterday.
I am so tired and quite upset. I can't see that Swampy can have very long with his continued weight loss. While I'm sure that steroids are bad for his CRF, I'm unconvinced that he'd live longer and have a quality of life, without them. What I may do is lower the dose by 1/4 pill per 48 hours. I think that going from 1 1/2 (7 1/2 mgs) to 1 (5mgs) is a big sudden drop. He didn't tolerate 5mgs about 6 months ago when we tried it.
I know my own vet says that the best dose is the lowest effective dose as they aren't good for him. I think that what is doing him in is his CRF but that the biggest factor in that's acceleration is the lack of sub cut fluids. They do keep it at bay longer than anything else does. Sorry this is so long, just letting off steam.