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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 33267
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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We have a 15 year old sphynx Bigglesworth who has had

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We have a 15 year old sphynx Bigglesworth who has had hyperthyroidism for 18 months. He is on carbimazole and prednisolone and been fine with that. Two weeks ago he had a blood test and check up that confirmed his levels are good, and that his liver and kidney function is good. He eats well, is hydrated. However, for at least 9 months his walking has deteriorated (he is very stiff like a woodentop - not sure if arthritis) and there are times of the day when he is agitated. He still purrs but it so hard to know if he is in any pain which we wouldn't want. We took him to the vet this morning and he had a thorough check, could find nothing wrong and felt it was likely to be his central nervous system and that tests etc, would be unrealistic bearing in mind his age. He gave Biggles a vetergesic injection to see if he made a difference, and although he perked up today, tonight he was more unsettled than normal. He ate well but was very restless. He has now had his prednisolone and has settled down. In your opinion is there is anything else that needs to be considered? I have also spoken to Biggles' breeder whose vet suggested he come off prednisolone over a phased period and then starts on metacam which just started me thinking that not all vets would propose the same way forward..... we just want to do the best for Bigglesworth.

I understand your concerns at this time and will address them as you presented them...

Yes, geriatric osteoarthritis is most likely.

Purring also indicates discomfort in cats.

Vetergesic (buprenoprhine) is a potent opiate and would be expected to provide up to 12 hours of analgesia. In cats, however, behavioral effects aren't uncommon. They may include excessive purring, pacing, and rubbing. His becoming unsettled suggests an adverse effect to the opiate which shouldn't be continued.

If he has tolerated the prednisolone well - and his blood tests indicate that that's the case - I see no reason to discontinue that steroid. Meloxicam (Metacam) is an alternative but it isn't expected to provide additional antiinflammatory activity and/or analgesia than does the prednisolone. Please note that you mustn't give a steroid such as prednisolone concomitantly with a nonsteroidal antiinflammatory drug (NSAID) such as meloxicam. That's a ticket for gastrointestinal ulceration. In addition, the NSAIDs bring their own possible adverse effects; for instance, meloxicam can be worrisome when renal insufficiency exists as is assuredly the case in a 15 year old Bigglesworth.

In summary, medically speaking you're doing as much as I could ask of you. Please consider adding fish oil to Bigglesworth diet at a dose of 40 mg/kg daily of the
EPA in the fish oil product you choose (a human generic is fine). The omega-3 fatty acids in fish oil are antiinflammatory. EPA is the most anti-inflammatory of the omega-3 fatty acids. In addition, consider either the over the counter Cosequin or prescription Dasequin available through his vet - neutraceuticals which might be of value and synergize safely with his prednisolone.

Please respond with further questions or concerns if you wish.

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Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience.